CAGE XP ARC 12X32X9MM 15°
|
Facility
|
IP
|
$14,000.00
|
|
Hospital Charge Code |
3004640
|
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
|
|
CALCITONIN (SALMON) 200 UNIT/ML INJECTION SOLUTION [20717]
|
Facility
|
IP
|
$29.68
|
|
Service Code
|
HCPCS J0630
|
Hospital Revenue Code
|
636
|
Min. Negotiated Rate |
$17.20 |
Max. Negotiated Rate |
$29.68 |
Rate for Payer: Aetna of WY Commercial/Medical Rental |
$29.09
|
Rate for Payer: Aetna of WY Medicare |
$19.00
|
Rate for Payer: Altius Commercial |
$28.49
|
Rate for Payer: Beech Street Commercial |
$29.09
|
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$28.79
|
Rate for Payer: Cash Price |
$20.77
|
Rate for Payer: ChoiceCare Network Commercial |
$28.79
|
Rate for Payer: Cigna of WY Commercial |
$29.09
|
Rate for Payer: Entrust Commercial |
$28.20
|
Rate for Payer: First Choice Health Commercial |
$28.20
|
Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$28.20
|
Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$18.10
|
Rate for Payer: HealthUtah PPO |
$29.68
|
Rate for Payer: Idaho Integrated Healthcare Commercial |
$28.79
|
Rate for Payer: Multiplan Medicare/VA |
$17.20
|
Rate for Payer: One Health Plan of WY PPO |
$29.09
|
Rate for Payer: PacificSource Commercial |
$26.71
|
Rate for Payer: PHCS PPO |
$29.09
|
Rate for Payer: Three Rivers PPO |
$22.26
|
Rate for Payer: TriWest Veterans Administration |
$18.10
|
Rate for Payer: United Healthcare Commercial |
$28.34
|
Rate for Payer: United Healthcare Medicare |
$18.10
|
Rate for Payer: WINHealth Partners Commercial |
$28.20
|
Rate for Payer: Wise Provider Network Commercial |
$28.20
|
|
CALCITONIN (SALMON) 200 UNIT/ML INJECTION SOLUTION [20717]
|
Facility
|
OP
|
$29.68
|
|
Service Code
|
HCPCS J0630
|
Hospital Revenue Code
|
636
|
Min. Negotiated Rate |
$16.07 |
Max. Negotiated Rate |
$29.68 |
Rate for Payer: Aetna of WY Commercial/Medical Rental |
$29.09
|
Rate for Payer: Aetna of WY Medicare |
$19.59
|
Rate for Payer: Altius Commercial |
$28.49
|
Rate for Payer: Beech Street Commercial |
$29.09
|
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$28.79
|
Rate for Payer: Cash Price |
$20.77
|
Rate for Payer: ChoiceCare Network Commercial |
$28.79
|
Rate for Payer: Cigna of WY Commercial |
$29.09
|
Rate for Payer: Entrust Commercial |
$28.20
|
Rate for Payer: First Choice Health Commercial |
$28.20
|
Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$28.20
|
Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$16.92
|
Rate for Payer: HealthUtah PPO |
$29.68
|
Rate for Payer: Idaho Integrated Healthcare Commercial |
$28.79
|
Rate for Payer: Multiplan Medicare/VA |
$16.07
|
Rate for Payer: One Health Plan of WY PPO |
$29.09
|
Rate for Payer: PacificSource Commercial |
$26.71
|
Rate for Payer: PHCS PPO |
$29.09
|
Rate for Payer: Three Rivers PPO |
$22.26
|
Rate for Payer: TriWest Veterans Administration |
$16.92
|
Rate for Payer: United Healthcare Commercial |
$28.34
|
Rate for Payer: United Healthcare Medicare |
$16.92
|
Rate for Payer: WINHealth Partners Commercial |
$29.09
|
Rate for Payer: Wise Provider Network Commercial |
$28.20
|
|
CALCITRIOL 0.25 MCG CAPSULE [19410]
|
Facility
|
IP
|
$17.95
|
|
Service Code
|
NDC 6068734511
|
Hospital Revenue Code
|
250
|
Min. Negotiated Rate |
$10.40 |
Max. Negotiated Rate |
$17.95 |
Rate for Payer: WINHealth Partners Commercial |
$17.05
|
Rate for Payer: Aetna of WY Commercial/Medical Rental |
$17.59
|
Rate for Payer: Aetna of WY Medicare |
$11.49
|
Rate for Payer: Altius Commercial |
$17.23
|
Rate for Payer: Beech Street Commercial |
$17.59
|
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$17.41
|
Rate for Payer: Cash Price |
$12.57
|
Rate for Payer: ChoiceCare Network Commercial |
$17.41
|
Rate for Payer: Cigna of WY Commercial |
$17.59
|
Rate for Payer: Entrust Commercial |
$17.05
|
Rate for Payer: First Choice Health Commercial |
$17.05
|
Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$17.05
|
Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$10.95
|
Rate for Payer: HealthUtah PPO |
$17.95
|
Rate for Payer: Idaho Integrated Healthcare Commercial |
$17.41
|
Rate for Payer: Multiplan Medicare/VA |
$10.40
|
Rate for Payer: One Health Plan of WY PPO |
$17.59
|
Rate for Payer: PacificSource Commercial |
$16.16
|
Rate for Payer: PHCS PPO |
$17.59
|
Rate for Payer: Three Rivers PPO |
$13.46
|
Rate for Payer: TriWest Veterans Administration |
$10.95
|
Rate for Payer: United Healthcare Commercial |
$17.14
|
Rate for Payer: United Healthcare Medicare |
$10.95
|
Rate for Payer: Wise Provider Network Commercial |
$17.05
|
|
CALCITRIOL 0.25 MCG CAPSULE [19410]
|
Facility
|
OP
|
$17.95
|
|
Service Code
|
NDC 6068734511
|
Hospital Revenue Code
|
250
|
Min. Negotiated Rate |
$9.72 |
Max. Negotiated Rate |
$17.95 |
Rate for Payer: Aetna of WY Commercial/Medical Rental |
$17.59
|
Rate for Payer: Aetna of WY Medicare |
$11.85
|
Rate for Payer: Altius Commercial |
$17.23
|
Rate for Payer: Beech Street Commercial |
$17.59
|
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$17.41
|
Rate for Payer: Cash Price |
$12.57
|
Rate for Payer: ChoiceCare Network Commercial |
$17.41
|
Rate for Payer: Cigna of WY Commercial |
$17.59
|
Rate for Payer: Entrust Commercial |
$17.05
|
Rate for Payer: First Choice Health Commercial |
$17.05
|
Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$17.05
|
Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$10.23
|
Rate for Payer: HealthUtah PPO |
$17.95
|
Rate for Payer: Idaho Integrated Healthcare Commercial |
$17.41
|
Rate for Payer: Multiplan Medicare/VA |
$9.72
|
Rate for Payer: One Health Plan of WY PPO |
$17.59
|
Rate for Payer: PacificSource Commercial |
$16.16
|
Rate for Payer: PHCS PPO |
$17.59
|
Rate for Payer: Three Rivers PPO |
$13.46
|
Rate for Payer: TriWest Veterans Administration |
$10.23
|
Rate for Payer: United Healthcare Commercial |
$17.14
|
Rate for Payer: United Healthcare Medicare |
$10.23
|
Rate for Payer: WINHealth Partners Commercial |
$17.59
|
Rate for Payer: Wise Provider Network Commercial |
$17.05
|
|
CALCIUM 200 MG (AS CALCIUM CARBONATE 500 MG) CHEWABLE TABLET [13579]
|
Facility
|
IP
|
$15.22
|
|
Service Code
|
NDC 6655300401
|
Hospital Revenue Code
|
250
|
Min. Negotiated Rate |
$8.82 |
Max. Negotiated Rate |
$15.22 |
Rate for Payer: Aetna of WY Commercial/Medical Rental |
$14.92
|
Rate for Payer: Aetna of WY Medicare |
$9.74
|
Rate for Payer: Altius Commercial |
$14.61
|
Rate for Payer: Beech Street Commercial |
$14.92
|
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$14.76
|
Rate for Payer: Cash Price |
$10.66
|
Rate for Payer: ChoiceCare Network Commercial |
$14.76
|
Rate for Payer: Cigna of WY Commercial |
$14.92
|
Rate for Payer: Entrust Commercial |
$14.46
|
Rate for Payer: First Choice Health Commercial |
$14.46
|
Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$14.46
|
Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$9.28
|
Rate for Payer: HealthUtah PPO |
$15.22
|
Rate for Payer: Idaho Integrated Healthcare Commercial |
$14.76
|
Rate for Payer: Multiplan Medicare/VA |
$8.82
|
Rate for Payer: One Health Plan of WY PPO |
$14.92
|
Rate for Payer: PacificSource Commercial |
$13.70
|
Rate for Payer: PHCS PPO |
$14.92
|
Rate for Payer: Three Rivers PPO |
$11.42
|
Rate for Payer: TriWest Veterans Administration |
$9.28
|
Rate for Payer: United Healthcare Commercial |
$14.54
|
Rate for Payer: United Healthcare Medicare |
$9.28
|
Rate for Payer: WINHealth Partners Commercial |
$14.46
|
Rate for Payer: Wise Provider Network Commercial |
$14.46
|
|
CALCIUM 200 MG (AS CALCIUM CARBONATE 500 MG) CHEWABLE TABLET [13579]
|
Facility
|
OP
|
$15.22
|
|
Service Code
|
NDC 6655300401
|
Hospital Revenue Code
|
250
|
Min. Negotiated Rate |
$8.24 |
Max. Negotiated Rate |
$15.22 |
Rate for Payer: Aetna of WY Commercial/Medical Rental |
$14.92
|
Rate for Payer: Aetna of WY Medicare |
$10.05
|
Rate for Payer: Altius Commercial |
$14.61
|
Rate for Payer: Beech Street Commercial |
$14.92
|
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$14.76
|
Rate for Payer: Cash Price |
$10.66
|
Rate for Payer: ChoiceCare Network Commercial |
$14.76
|
Rate for Payer: Cigna of WY Commercial |
$14.92
|
Rate for Payer: Entrust Commercial |
$14.46
|
Rate for Payer: First Choice Health Commercial |
$14.46
|
Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$14.46
|
Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$8.68
|
Rate for Payer: HealthUtah PPO |
$15.22
|
Rate for Payer: Idaho Integrated Healthcare Commercial |
$14.76
|
Rate for Payer: Multiplan Medicare/VA |
$8.24
|
Rate for Payer: One Health Plan of WY PPO |
$14.92
|
Rate for Payer: PacificSource Commercial |
$13.70
|
Rate for Payer: PHCS PPO |
$14.92
|
Rate for Payer: Three Rivers PPO |
$11.42
|
Rate for Payer: TriWest Veterans Administration |
$8.68
|
Rate for Payer: United Healthcare Commercial |
$14.54
|
Rate for Payer: United Healthcare Medicare |
$8.68
|
Rate for Payer: WINHealth Partners Commercial |
$14.92
|
Rate for Payer: Wise Provider Network Commercial |
$14.46
|
|
CALCIUM 400 MG (AS CALCIUM CARBONATE 1,000 MG) CHEWABLE TABLET [9718]
|
Facility
|
IP
|
$15.22
|
|
Service Code
|
NDC 3680088124
|
Hospital Revenue Code
|
250
|
Min. Negotiated Rate |
$8.82 |
Max. Negotiated Rate |
$15.22 |
Rate for Payer: Aetna of WY Commercial/Medical Rental |
$14.92
|
Rate for Payer: Aetna of WY Medicare |
$9.74
|
Rate for Payer: Altius Commercial |
$14.61
|
Rate for Payer: Beech Street Commercial |
$14.92
|
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$14.76
|
Rate for Payer: Cash Price |
$10.65
|
Rate for Payer: ChoiceCare Network Commercial |
$14.76
|
Rate for Payer: Cigna of WY Commercial |
$14.92
|
Rate for Payer: Entrust Commercial |
$14.46
|
Rate for Payer: First Choice Health Commercial |
$14.46
|
Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$14.46
|
Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$9.28
|
Rate for Payer: HealthUtah PPO |
$15.22
|
Rate for Payer: Idaho Integrated Healthcare Commercial |
$14.76
|
Rate for Payer: Multiplan Medicare/VA |
$8.82
|
Rate for Payer: One Health Plan of WY PPO |
$14.92
|
Rate for Payer: PacificSource Commercial |
$13.70
|
Rate for Payer: PHCS PPO |
$14.92
|
Rate for Payer: Three Rivers PPO |
$11.42
|
Rate for Payer: TriWest Veterans Administration |
$9.28
|
Rate for Payer: United Healthcare Commercial |
$14.54
|
Rate for Payer: United Healthcare Medicare |
$9.28
|
Rate for Payer: WINHealth Partners Commercial |
$14.46
|
Rate for Payer: Wise Provider Network Commercial |
$14.46
|
|
CALCIUM 400 MG (AS CALCIUM CARBONATE 1,000 MG) CHEWABLE TABLET [9718]
|
Facility
|
IP
|
$15.15
|
|
Service Code
|
NDC 8770143612
|
Hospital Revenue Code
|
250
|
Min. Negotiated Rate |
$8.78 |
Max. Negotiated Rate |
$15.15 |
Rate for Payer: Aetna of WY Commercial/Medical Rental |
$14.85
|
Rate for Payer: Aetna of WY Medicare |
$9.70
|
Rate for Payer: Altius Commercial |
$14.54
|
Rate for Payer: Beech Street Commercial |
$14.85
|
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$14.70
|
Rate for Payer: Cash Price |
$10.61
|
Rate for Payer: ChoiceCare Network Commercial |
$14.70
|
Rate for Payer: Cigna of WY Commercial |
$14.85
|
Rate for Payer: Entrust Commercial |
$14.39
|
Rate for Payer: First Choice Health Commercial |
$14.39
|
Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$14.39
|
Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$9.24
|
Rate for Payer: HealthUtah PPO |
$15.15
|
Rate for Payer: Idaho Integrated Healthcare Commercial |
$14.70
|
Rate for Payer: Multiplan Medicare/VA |
$8.78
|
Rate for Payer: One Health Plan of WY PPO |
$14.85
|
Rate for Payer: PacificSource Commercial |
$13.64
|
Rate for Payer: PHCS PPO |
$14.85
|
Rate for Payer: Three Rivers PPO |
$11.36
|
Rate for Payer: TriWest Veterans Administration |
$9.24
|
Rate for Payer: United Healthcare Commercial |
$14.47
|
Rate for Payer: United Healthcare Medicare |
$9.24
|
Rate for Payer: WINHealth Partners Commercial |
$14.39
|
Rate for Payer: Wise Provider Network Commercial |
$14.39
|
|
CALCIUM 400 MG (AS CALCIUM CARBONATE 1,000 MG) CHEWABLE TABLET [9718]
|
Facility
|
IP
|
$15.15
|
|
Service Code
|
NDC 2438559523
|
Hospital Revenue Code
|
250
|
Min. Negotiated Rate |
$8.78 |
Max. Negotiated Rate |
$15.15 |
Rate for Payer: Aetna of WY Commercial/Medical Rental |
$14.85
|
Rate for Payer: Aetna of WY Medicare |
$9.70
|
Rate for Payer: Altius Commercial |
$14.54
|
Rate for Payer: Beech Street Commercial |
$14.85
|
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$14.70
|
Rate for Payer: Cash Price |
$10.61
|
Rate for Payer: ChoiceCare Network Commercial |
$14.70
|
Rate for Payer: Cigna of WY Commercial |
$14.85
|
Rate for Payer: Entrust Commercial |
$14.39
|
Rate for Payer: First Choice Health Commercial |
$14.39
|
Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$14.39
|
Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$9.24
|
Rate for Payer: HealthUtah PPO |
$15.15
|
Rate for Payer: Idaho Integrated Healthcare Commercial |
$14.70
|
Rate for Payer: Multiplan Medicare/VA |
$8.78
|
Rate for Payer: One Health Plan of WY PPO |
$14.85
|
Rate for Payer: PacificSource Commercial |
$13.64
|
Rate for Payer: PHCS PPO |
$14.85
|
Rate for Payer: Three Rivers PPO |
$11.36
|
Rate for Payer: TriWest Veterans Administration |
$9.24
|
Rate for Payer: United Healthcare Commercial |
$14.47
|
Rate for Payer: United Healthcare Medicare |
$9.24
|
Rate for Payer: WINHealth Partners Commercial |
$14.39
|
Rate for Payer: Wise Provider Network Commercial |
$14.39
|
|
CALCIUM 400 MG (AS CALCIUM CARBONATE 1,000 MG) CHEWABLE TABLET [9718]
|
Facility
|
OP
|
$15.15
|
|
Service Code
|
NDC 2438559523
|
Hospital Revenue Code
|
250
|
Min. Negotiated Rate |
$8.20 |
Max. Negotiated Rate |
$15.15 |
Rate for Payer: Aetna of WY Commercial/Medical Rental |
$14.85
|
Rate for Payer: Aetna of WY Medicare |
$10.00
|
Rate for Payer: Altius Commercial |
$14.54
|
Rate for Payer: Beech Street Commercial |
$14.85
|
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$14.70
|
Rate for Payer: Cash Price |
$10.61
|
Rate for Payer: ChoiceCare Network Commercial |
$14.70
|
Rate for Payer: Cigna of WY Commercial |
$14.85
|
Rate for Payer: Entrust Commercial |
$14.39
|
Rate for Payer: First Choice Health Commercial |
$14.39
|
Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$14.39
|
Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$8.64
|
Rate for Payer: HealthUtah PPO |
$15.15
|
Rate for Payer: Idaho Integrated Healthcare Commercial |
$14.70
|
Rate for Payer: Multiplan Medicare/VA |
$8.20
|
Rate for Payer: One Health Plan of WY PPO |
$14.85
|
Rate for Payer: PacificSource Commercial |
$13.64
|
Rate for Payer: PHCS PPO |
$14.85
|
Rate for Payer: Three Rivers PPO |
$11.36
|
Rate for Payer: TriWest Veterans Administration |
$8.64
|
Rate for Payer: United Healthcare Commercial |
$14.47
|
Rate for Payer: United Healthcare Medicare |
$8.64
|
Rate for Payer: WINHealth Partners Commercial |
$14.85
|
Rate for Payer: Wise Provider Network Commercial |
$14.39
|
|
CALCIUM 400 MG (AS CALCIUM CARBONATE 1,000 MG) CHEWABLE TABLET [9718]
|
Facility
|
OP
|
$15.22
|
|
Service Code
|
NDC 3680088124
|
Hospital Revenue Code
|
250
|
Min. Negotiated Rate |
$8.24 |
Max. Negotiated Rate |
$15.22 |
Rate for Payer: Aetna of WY Commercial/Medical Rental |
$14.92
|
Rate for Payer: Aetna of WY Medicare |
$10.05
|
Rate for Payer: Altius Commercial |
$14.61
|
Rate for Payer: Beech Street Commercial |
$14.92
|
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$14.76
|
Rate for Payer: Cash Price |
$10.65
|
Rate for Payer: ChoiceCare Network Commercial |
$14.76
|
Rate for Payer: Cigna of WY Commercial |
$14.92
|
Rate for Payer: Entrust Commercial |
$14.46
|
Rate for Payer: First Choice Health Commercial |
$14.46
|
Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$14.46
|
Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$8.68
|
Rate for Payer: HealthUtah PPO |
$15.22
|
Rate for Payer: Idaho Integrated Healthcare Commercial |
$14.76
|
Rate for Payer: Multiplan Medicare/VA |
$8.24
|
Rate for Payer: One Health Plan of WY PPO |
$14.92
|
Rate for Payer: PacificSource Commercial |
$13.70
|
Rate for Payer: PHCS PPO |
$14.92
|
Rate for Payer: Three Rivers PPO |
$11.42
|
Rate for Payer: TriWest Veterans Administration |
$8.68
|
Rate for Payer: United Healthcare Commercial |
$14.54
|
Rate for Payer: United Healthcare Medicare |
$8.68
|
Rate for Payer: WINHealth Partners Commercial |
$14.92
|
Rate for Payer: Wise Provider Network Commercial |
$14.46
|
|
CALCIUM 400 MG (AS CALCIUM CARBONATE 1,000 MG) CHEWABLE TABLET [9718]
|
Facility
|
OP
|
$15.15
|
|
Service Code
|
NDC 8770143612
|
Hospital Revenue Code
|
250
|
Min. Negotiated Rate |
$8.20 |
Max. Negotiated Rate |
$15.15 |
Rate for Payer: Aetna of WY Commercial/Medical Rental |
$14.85
|
Rate for Payer: Aetna of WY Medicare |
$10.00
|
Rate for Payer: Altius Commercial |
$14.54
|
Rate for Payer: Beech Street Commercial |
$14.85
|
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$14.70
|
Rate for Payer: Cash Price |
$10.61
|
Rate for Payer: ChoiceCare Network Commercial |
$14.70
|
Rate for Payer: Cigna of WY Commercial |
$14.85
|
Rate for Payer: Entrust Commercial |
$14.39
|
Rate for Payer: First Choice Health Commercial |
$14.39
|
Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$14.39
|
Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$8.64
|
Rate for Payer: HealthUtah PPO |
$15.15
|
Rate for Payer: Idaho Integrated Healthcare Commercial |
$14.70
|
Rate for Payer: Multiplan Medicare/VA |
$8.20
|
Rate for Payer: One Health Plan of WY PPO |
$14.85
|
Rate for Payer: PacificSource Commercial |
$13.64
|
Rate for Payer: PHCS PPO |
$14.85
|
Rate for Payer: Three Rivers PPO |
$11.36
|
Rate for Payer: TriWest Veterans Administration |
$8.64
|
Rate for Payer: United Healthcare Commercial |
$14.47
|
Rate for Payer: United Healthcare Medicare |
$8.64
|
Rate for Payer: WINHealth Partners Commercial |
$14.85
|
Rate for Payer: Wise Provider Network Commercial |
$14.39
|
|
CALCIUM ACETATE 952 MG-ALUMINUM SULFATE 1,347 MG TOPICAL POWDER PACKET [97619]
|
Facility
|
OP
|
$17.66
|
|
Service Code
|
NDC 5707400177
|
Hospital Revenue Code
|
250
|
Min. Negotiated Rate |
$9.56 |
Max. Negotiated Rate |
$17.66 |
Rate for Payer: Aetna of WY Commercial/Medical Rental |
$17.31
|
Rate for Payer: Aetna of WY Medicare |
$11.66
|
Rate for Payer: Altius Commercial |
$16.95
|
Rate for Payer: Beech Street Commercial |
$17.31
|
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$17.13
|
Rate for Payer: Cash Price |
$12.36
|
Rate for Payer: ChoiceCare Network Commercial |
$17.13
|
Rate for Payer: Cigna of WY Commercial |
$17.31
|
Rate for Payer: Entrust Commercial |
$16.78
|
Rate for Payer: First Choice Health Commercial |
$16.78
|
Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$16.78
|
Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$10.07
|
Rate for Payer: HealthUtah PPO |
$17.66
|
Rate for Payer: Idaho Integrated Healthcare Commercial |
$17.13
|
Rate for Payer: Multiplan Medicare/VA |
$9.56
|
Rate for Payer: One Health Plan of WY PPO |
$17.31
|
Rate for Payer: PacificSource Commercial |
$15.89
|
Rate for Payer: PHCS PPO |
$17.31
|
Rate for Payer: Three Rivers PPO |
$13.24
|
Rate for Payer: TriWest Veterans Administration |
$10.07
|
Rate for Payer: United Healthcare Commercial |
$16.87
|
Rate for Payer: United Healthcare Medicare |
$10.07
|
Rate for Payer: WINHealth Partners Commercial |
$17.31
|
Rate for Payer: Wise Provider Network Commercial |
$16.78
|
|
CALCIUM ACETATE 952 MG-ALUMINUM SULFATE 1,347 MG TOPICAL POWDER PACKET [97619]
|
Facility
|
IP
|
$17.12
|
|
Service Code
|
NDC 1650002322
|
Hospital Revenue Code
|
250
|
Min. Negotiated Rate |
$9.92 |
Max. Negotiated Rate |
$17.12 |
Rate for Payer: Aetna of WY Commercial/Medical Rental |
$16.78
|
Rate for Payer: Aetna of WY Medicare |
$10.96
|
Rate for Payer: Altius Commercial |
$16.44
|
Rate for Payer: Beech Street Commercial |
$16.78
|
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$16.61
|
Rate for Payer: Cash Price |
$11.98
|
Rate for Payer: ChoiceCare Network Commercial |
$16.61
|
Rate for Payer: Cigna of WY Commercial |
$16.78
|
Rate for Payer: Entrust Commercial |
$16.26
|
Rate for Payer: First Choice Health Commercial |
$16.26
|
Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$16.26
|
Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$10.44
|
Rate for Payer: HealthUtah PPO |
$17.12
|
Rate for Payer: Idaho Integrated Healthcare Commercial |
$16.61
|
Rate for Payer: Multiplan Medicare/VA |
$9.92
|
Rate for Payer: One Health Plan of WY PPO |
$16.78
|
Rate for Payer: PacificSource Commercial |
$15.41
|
Rate for Payer: PHCS PPO |
$16.78
|
Rate for Payer: Three Rivers PPO |
$12.84
|
Rate for Payer: TriWest Veterans Administration |
$10.44
|
Rate for Payer: United Healthcare Commercial |
$16.35
|
Rate for Payer: United Healthcare Medicare |
$10.44
|
Rate for Payer: WINHealth Partners Commercial |
$16.26
|
Rate for Payer: Wise Provider Network Commercial |
$16.26
|
|
CALCIUM ACETATE 952 MG-ALUMINUM SULFATE 1,347 MG TOPICAL POWDER PACKET [97619]
|
Facility
|
IP
|
$17.66
|
|
Service Code
|
NDC 5707400177
|
Hospital Revenue Code
|
250
|
Min. Negotiated Rate |
$10.23 |
Max. Negotiated Rate |
$17.66 |
Rate for Payer: Aetna of WY Commercial/Medical Rental |
$17.31
|
Rate for Payer: Aetna of WY Medicare |
$11.30
|
Rate for Payer: Altius Commercial |
$16.95
|
Rate for Payer: Beech Street Commercial |
$17.31
|
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$17.13
|
Rate for Payer: Cash Price |
$12.36
|
Rate for Payer: ChoiceCare Network Commercial |
$17.13
|
Rate for Payer: Cigna of WY Commercial |
$17.31
|
Rate for Payer: Entrust Commercial |
$16.78
|
Rate for Payer: First Choice Health Commercial |
$16.78
|
Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$16.78
|
Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$10.77
|
Rate for Payer: HealthUtah PPO |
$17.66
|
Rate for Payer: Idaho Integrated Healthcare Commercial |
$17.13
|
Rate for Payer: Multiplan Medicare/VA |
$10.23
|
Rate for Payer: One Health Plan of WY PPO |
$17.31
|
Rate for Payer: PacificSource Commercial |
$15.89
|
Rate for Payer: PHCS PPO |
$17.31
|
Rate for Payer: Three Rivers PPO |
$13.24
|
Rate for Payer: TriWest Veterans Administration |
$10.77
|
Rate for Payer: United Healthcare Commercial |
$16.87
|
Rate for Payer: United Healthcare Medicare |
$10.77
|
Rate for Payer: WINHealth Partners Commercial |
$16.78
|
Rate for Payer: Wise Provider Network Commercial |
$16.78
|
|
CALCIUM ACETATE 952 MG-ALUMINUM SULFATE 1,347 MG TOPICAL POWDER PACKET [97619]
|
Facility
|
OP
|
$17.12
|
|
Service Code
|
NDC 1650002322
|
Hospital Revenue Code
|
250
|
Min. Negotiated Rate |
$9.27 |
Max. Negotiated Rate |
$17.12 |
Rate for Payer: Aetna of WY Commercial/Medical Rental |
$16.78
|
Rate for Payer: Aetna of WY Medicare |
$11.30
|
Rate for Payer: Altius Commercial |
$16.44
|
Rate for Payer: Beech Street Commercial |
$16.78
|
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$16.61
|
Rate for Payer: Cash Price |
$11.98
|
Rate for Payer: ChoiceCare Network Commercial |
$16.61
|
Rate for Payer: Cigna of WY Commercial |
$16.78
|
Rate for Payer: Entrust Commercial |
$16.26
|
Rate for Payer: First Choice Health Commercial |
$16.26
|
Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$16.26
|
Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$9.76
|
Rate for Payer: HealthUtah PPO |
$17.12
|
Rate for Payer: Idaho Integrated Healthcare Commercial |
$16.61
|
Rate for Payer: Multiplan Medicare/VA |
$9.27
|
Rate for Payer: One Health Plan of WY PPO |
$16.78
|
Rate for Payer: PacificSource Commercial |
$15.41
|
Rate for Payer: PHCS PPO |
$16.78
|
Rate for Payer: Three Rivers PPO |
$12.84
|
Rate for Payer: TriWest Veterans Administration |
$9.76
|
Rate for Payer: United Healthcare Commercial |
$16.35
|
Rate for Payer: United Healthcare Medicare |
$9.76
|
Rate for Payer: WINHealth Partners Commercial |
$16.78
|
Rate for Payer: Wise Provider Network Commercial |
$16.26
|
|
CALCIUM CARBONATE 500 MG-VITAMIN D3 5 MCG (200 UNIT) TABLET [38648]
|
Facility
|
OP
|
$15.19
|
|
Service Code
|
NDC 1000670038
|
Hospital Revenue Code
|
250
|
Min. Negotiated Rate |
$8.23 |
Max. Negotiated Rate |
$15.19 |
Rate for Payer: Aetna of WY Commercial/Medical Rental |
$14.89
|
Rate for Payer: Aetna of WY Medicare |
$10.03
|
Rate for Payer: Altius Commercial |
$14.58
|
Rate for Payer: Beech Street Commercial |
$14.89
|
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$14.73
|
Rate for Payer: Cash Price |
$10.63
|
Rate for Payer: ChoiceCare Network Commercial |
$14.73
|
Rate for Payer: Cigna of WY Commercial |
$14.89
|
Rate for Payer: Entrust Commercial |
$14.43
|
Rate for Payer: First Choice Health Commercial |
$14.43
|
Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$14.43
|
Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$8.66
|
Rate for Payer: HealthUtah PPO |
$15.19
|
Rate for Payer: Idaho Integrated Healthcare Commercial |
$14.73
|
Rate for Payer: Multiplan Medicare/VA |
$8.23
|
Rate for Payer: One Health Plan of WY PPO |
$14.89
|
Rate for Payer: PacificSource Commercial |
$13.67
|
Rate for Payer: PHCS PPO |
$14.89
|
Rate for Payer: Three Rivers PPO |
$11.39
|
Rate for Payer: TriWest Veterans Administration |
$8.66
|
Rate for Payer: United Healthcare Commercial |
$14.51
|
Rate for Payer: United Healthcare Medicare |
$8.66
|
Rate for Payer: WINHealth Partners Commercial |
$14.89
|
Rate for Payer: Wise Provider Network Commercial |
$14.43
|
|
CALCIUM CARBONATE 500 MG-VITAMIN D3 5 MCG (200 UNIT) TABLET [38648]
|
Facility
|
IP
|
$15.19
|
|
Service Code
|
NDC 1000670038
|
Hospital Revenue Code
|
250
|
Min. Negotiated Rate |
$8.80 |
Max. Negotiated Rate |
$15.19 |
Rate for Payer: Aetna of WY Commercial/Medical Rental |
$14.89
|
Rate for Payer: Aetna of WY Medicare |
$9.72
|
Rate for Payer: Altius Commercial |
$14.58
|
Rate for Payer: Beech Street Commercial |
$14.89
|
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$14.73
|
Rate for Payer: Cash Price |
$10.63
|
Rate for Payer: ChoiceCare Network Commercial |
$14.73
|
Rate for Payer: Cigna of WY Commercial |
$14.89
|
Rate for Payer: Entrust Commercial |
$14.43
|
Rate for Payer: First Choice Health Commercial |
$14.43
|
Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$14.43
|
Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$9.27
|
Rate for Payer: HealthUtah PPO |
$15.19
|
Rate for Payer: Idaho Integrated Healthcare Commercial |
$14.73
|
Rate for Payer: Multiplan Medicare/VA |
$8.80
|
Rate for Payer: One Health Plan of WY PPO |
$14.89
|
Rate for Payer: PacificSource Commercial |
$13.67
|
Rate for Payer: PHCS PPO |
$14.89
|
Rate for Payer: Three Rivers PPO |
$11.39
|
Rate for Payer: TriWest Veterans Administration |
$9.27
|
Rate for Payer: United Healthcare Commercial |
$14.51
|
Rate for Payer: United Healthcare Medicare |
$9.27
|
Rate for Payer: WINHealth Partners Commercial |
$14.43
|
Rate for Payer: Wise Provider Network Commercial |
$14.43
|
|
CALCIUM CARBONATE 600 MG-VITAMIN D3 10 MCG (400 UNIT) TABLET [42441]
|
Facility
|
OP
|
$15.09
|
|
Service Code
|
NDC 8068113900
|
Hospital Revenue Code
|
250
|
Min. Negotiated Rate |
$8.17 |
Max. Negotiated Rate |
$15.09 |
Rate for Payer: Aetna of WY Commercial/Medical Rental |
$14.79
|
Rate for Payer: Aetna of WY Medicare |
$9.96
|
Rate for Payer: Altius Commercial |
$14.49
|
Rate for Payer: Beech Street Commercial |
$14.79
|
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$14.64
|
Rate for Payer: Cash Price |
$10.56
|
Rate for Payer: ChoiceCare Network Commercial |
$14.64
|
Rate for Payer: Cigna of WY Commercial |
$14.79
|
Rate for Payer: Entrust Commercial |
$14.34
|
Rate for Payer: First Choice Health Commercial |
$14.34
|
Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$14.34
|
Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$8.60
|
Rate for Payer: HealthUtah PPO |
$15.09
|
Rate for Payer: Idaho Integrated Healthcare Commercial |
$14.64
|
Rate for Payer: Multiplan Medicare/VA |
$8.17
|
Rate for Payer: One Health Plan of WY PPO |
$14.79
|
Rate for Payer: PacificSource Commercial |
$13.58
|
Rate for Payer: PHCS PPO |
$14.79
|
Rate for Payer: Three Rivers PPO |
$11.32
|
Rate for Payer: TriWest Veterans Administration |
$8.60
|
Rate for Payer: United Healthcare Commercial |
$14.41
|
Rate for Payer: United Healthcare Medicare |
$8.60
|
Rate for Payer: WINHealth Partners Commercial |
$14.79
|
Rate for Payer: Wise Provider Network Commercial |
$14.34
|
|
CALCIUM CARBONATE 600 MG-VITAMIN D3 10 MCG (400 UNIT) TABLET [42441]
|
Facility
|
IP
|
$15.09
|
|
Service Code
|
NDC 8068113900
|
Hospital Revenue Code
|
250
|
Min. Negotiated Rate |
$8.74 |
Max. Negotiated Rate |
$15.09 |
Rate for Payer: Aetna of WY Commercial/Medical Rental |
$14.79
|
Rate for Payer: Aetna of WY Medicare |
$9.66
|
Rate for Payer: Altius Commercial |
$14.49
|
Rate for Payer: Beech Street Commercial |
$14.79
|
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$14.64
|
Rate for Payer: Cash Price |
$10.56
|
Rate for Payer: ChoiceCare Network Commercial |
$14.64
|
Rate for Payer: Cigna of WY Commercial |
$14.79
|
Rate for Payer: Entrust Commercial |
$14.34
|
Rate for Payer: First Choice Health Commercial |
$14.34
|
Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$14.34
|
Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$9.20
|
Rate for Payer: HealthUtah PPO |
$15.09
|
Rate for Payer: Idaho Integrated Healthcare Commercial |
$14.64
|
Rate for Payer: Multiplan Medicare/VA |
$8.74
|
Rate for Payer: One Health Plan of WY PPO |
$14.79
|
Rate for Payer: PacificSource Commercial |
$13.58
|
Rate for Payer: PHCS PPO |
$14.79
|
Rate for Payer: Three Rivers PPO |
$11.32
|
Rate for Payer: TriWest Veterans Administration |
$9.20
|
Rate for Payer: United Healthcare Commercial |
$14.41
|
Rate for Payer: United Healthcare Medicare |
$9.20
|
Rate for Payer: WINHealth Partners Commercial |
$14.34
|
Rate for Payer: Wise Provider Network Commercial |
$14.34
|
|
CALCIUM CHLORIDE 100 MG/ML (10 %) INTRAVENOUS SYRINGE [24708]
|
Facility
|
IP
|
$18.60
|
|
Service Code
|
NDC 6425390030
|
Hospital Revenue Code
|
250
|
Min. Negotiated Rate |
$10.78 |
Max. Negotiated Rate |
$18.60 |
Rate for Payer: Aetna of WY Commercial/Medical Rental |
$18.23
|
Rate for Payer: Aetna of WY Medicare |
$11.90
|
Rate for Payer: Altius Commercial |
$17.86
|
Rate for Payer: Beech Street Commercial |
$18.23
|
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$18.04
|
Rate for Payer: Cash Price |
$13.02
|
Rate for Payer: ChoiceCare Network Commercial |
$18.04
|
Rate for Payer: Cigna of WY Commercial |
$18.23
|
Rate for Payer: Entrust Commercial |
$17.67
|
Rate for Payer: First Choice Health Commercial |
$17.67
|
Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$17.67
|
Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$11.35
|
Rate for Payer: HealthUtah PPO |
$18.60
|
Rate for Payer: Idaho Integrated Healthcare Commercial |
$18.04
|
Rate for Payer: Multiplan Medicare/VA |
$10.78
|
Rate for Payer: One Health Plan of WY PPO |
$18.23
|
Rate for Payer: PacificSource Commercial |
$16.74
|
Rate for Payer: PHCS PPO |
$18.23
|
Rate for Payer: Three Rivers PPO |
$13.95
|
Rate for Payer: TriWest Veterans Administration |
$11.35
|
Rate for Payer: United Healthcare Commercial |
$17.76
|
Rate for Payer: United Healthcare Medicare |
$11.35
|
Rate for Payer: WINHealth Partners Commercial |
$17.67
|
Rate for Payer: Wise Provider Network Commercial |
$17.67
|
|
CALCIUM CHLORIDE 100 MG/ML (10 %) INTRAVENOUS SYRINGE [24708]
|
Facility
|
OP
|
$18.60
|
|
Service Code
|
NDC 6425390030
|
Hospital Revenue Code
|
250
|
Min. Negotiated Rate |
$10.07 |
Max. Negotiated Rate |
$18.60 |
Rate for Payer: Aetna of WY Commercial/Medical Rental |
$18.23
|
Rate for Payer: Aetna of WY Medicare |
$12.28
|
Rate for Payer: Altius Commercial |
$17.86
|
Rate for Payer: Beech Street Commercial |
$18.23
|
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$18.04
|
Rate for Payer: Cash Price |
$13.02
|
Rate for Payer: ChoiceCare Network Commercial |
$18.04
|
Rate for Payer: Cigna of WY Commercial |
$18.23
|
Rate for Payer: Entrust Commercial |
$17.67
|
Rate for Payer: First Choice Health Commercial |
$17.67
|
Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$17.67
|
Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$10.60
|
Rate for Payer: HealthUtah PPO |
$18.60
|
Rate for Payer: Idaho Integrated Healthcare Commercial |
$18.04
|
Rate for Payer: Multiplan Medicare/VA |
$10.07
|
Rate for Payer: One Health Plan of WY PPO |
$18.23
|
Rate for Payer: PacificSource Commercial |
$16.74
|
Rate for Payer: PHCS PPO |
$18.23
|
Rate for Payer: Three Rivers PPO |
$13.95
|
Rate for Payer: TriWest Veterans Administration |
$10.60
|
Rate for Payer: United Healthcare Commercial |
$17.76
|
Rate for Payer: United Healthcare Medicare |
$10.60
|
Rate for Payer: WINHealth Partners Commercial |
$18.23
|
Rate for Payer: Wise Provider Network Commercial |
$17.67
|
|
CALCIUM GLUCONATE 1 GRAM/50 ML IN SODIUM CHLORIDE, ISO-OSM IV SOLUTION [154650]
|
Facility
|
OP
|
$16.58
|
|
Service Code
|
HCPCS J0612
|
Hospital Revenue Code
|
636
|
Min. Negotiated Rate |
$8.98 |
Max. Negotiated Rate |
$16.58 |
Rate for Payer: Aetna of WY Commercial/Medical Rental |
$16.25
|
Rate for Payer: Aetna of WY Medicare |
$10.94
|
Rate for Payer: Altius Commercial |
$15.92
|
Rate for Payer: Beech Street Commercial |
$16.25
|
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$16.08
|
Rate for Payer: Cash Price |
$11.61
|
Rate for Payer: ChoiceCare Network Commercial |
$16.08
|
Rate for Payer: Cigna of WY Commercial |
$16.25
|
Rate for Payer: Entrust Commercial |
$15.75
|
Rate for Payer: First Choice Health Commercial |
$15.75
|
Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$15.75
|
Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$9.45
|
Rate for Payer: HealthUtah PPO |
$16.58
|
Rate for Payer: Idaho Integrated Healthcare Commercial |
$16.08
|
Rate for Payer: Multiplan Medicare/VA |
$8.98
|
Rate for Payer: One Health Plan of WY PPO |
$16.25
|
Rate for Payer: PacificSource Commercial |
$14.92
|
Rate for Payer: PHCS PPO |
$16.25
|
Rate for Payer: Three Rivers PPO |
$12.44
|
Rate for Payer: TriWest Veterans Administration |
$9.45
|
Rate for Payer: United Healthcare Commercial |
$15.83
|
Rate for Payer: United Healthcare Medicare |
$9.45
|
Rate for Payer: WINHealth Partners Commercial |
$16.25
|
Rate for Payer: Wise Provider Network Commercial |
$15.75
|
|
CALCIUM GLUCONATE 1 GRAM/50 ML IN SODIUM CHLORIDE, ISO-OSM IV SOLUTION [154650]
|
Facility
|
IP
|
$16.58
|
|
Service Code
|
HCPCS J0612
|
Hospital Revenue Code
|
636
|
Min. Negotiated Rate |
$9.61 |
Max. Negotiated Rate |
$16.58 |
Rate for Payer: Aetna of WY Commercial/Medical Rental |
$16.25
|
Rate for Payer: Aetna of WY Medicare |
$10.61
|
Rate for Payer: Altius Commercial |
$15.92
|
Rate for Payer: Beech Street Commercial |
$16.25
|
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$16.08
|
Rate for Payer: Cash Price |
$11.61
|
Rate for Payer: ChoiceCare Network Commercial |
$16.08
|
Rate for Payer: Cigna of WY Commercial |
$16.25
|
Rate for Payer: Entrust Commercial |
$15.75
|
Rate for Payer: First Choice Health Commercial |
$15.75
|
Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$15.75
|
Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$10.11
|
Rate for Payer: HealthUtah PPO |
$16.58
|
Rate for Payer: Idaho Integrated Healthcare Commercial |
$16.08
|
Rate for Payer: Multiplan Medicare/VA |
$9.61
|
Rate for Payer: One Health Plan of WY PPO |
$16.25
|
Rate for Payer: PacificSource Commercial |
$14.92
|
Rate for Payer: PHCS PPO |
$16.25
|
Rate for Payer: Three Rivers PPO |
$12.44
|
Rate for Payer: TriWest Veterans Administration |
$10.11
|
Rate for Payer: United Healthcare Commercial |
$15.83
|
Rate for Payer: United Healthcare Medicare |
$10.11
|
Rate for Payer: WINHealth Partners Commercial |
$15.75
|
Rate for Payer: Wise Provider Network Commercial |
$15.75
|
|