|
CANNULA O2 NASAL PREMIEE
|
Facility
|
IP
|
$8.79
|
|
| Hospital Charge Code |
2100120
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$5.09 |
| Max. Negotiated Rate |
$8.79 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$8.61
|
| Rate for Payer: Aetna of WY Medicare |
$5.63
|
| Rate for Payer: Altius Commercial |
$8.44
|
| Rate for Payer: Beech Street Commercial |
$8.61
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$8.53
|
| Rate for Payer: Cash Price |
$6.15
|
| Rate for Payer: ChoiceCare Network Commercial |
$8.53
|
| Rate for Payer: Cigna of WY Commercial |
$8.61
|
| Rate for Payer: Entrust Commercial |
$8.35
|
| Rate for Payer: First Choice Health Commercial |
$8.35
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$8.35
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$5.36
|
| Rate for Payer: HealthUtah PPO |
$8.79
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$8.53
|
| Rate for Payer: Multiplan Medicare/VA |
$5.09
|
| Rate for Payer: One Health Plan of WY PPO |
$8.61
|
| Rate for Payer: PacificSource Commercial |
$7.91
|
| Rate for Payer: PHCS PPO |
$8.61
|
| Rate for Payer: Three Rivers PPO |
$6.59
|
| Rate for Payer: TriWest Veterans Administration |
$5.36
|
| Rate for Payer: United Healthcare Commercial |
$8.39
|
| Rate for Payer: United Healthcare Medicare |
$5.36
|
| Rate for Payer: WINHealth Partners Commercial |
$8.35
|
| Rate for Payer: Wise Provider Network Commercial |
$8.35
|
|
|
CANNULA O2 NASAL PREMIEE
|
Facility
|
OP
|
$8.79
|
|
| Hospital Charge Code |
2100120
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$4.76 |
| Max. Negotiated Rate |
$8.79 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$8.61
|
| Rate for Payer: Aetna of WY Medicare |
$5.80
|
| Rate for Payer: Altius Commercial |
$8.44
|
| Rate for Payer: Beech Street Commercial |
$8.61
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$8.53
|
| Rate for Payer: Cash Price |
$6.15
|
| Rate for Payer: ChoiceCare Network Commercial |
$8.53
|
| Rate for Payer: Cigna of WY Commercial |
$8.61
|
| Rate for Payer: Entrust Commercial |
$8.35
|
| Rate for Payer: First Choice Health Commercial |
$8.35
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$8.35
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$5.01
|
| Rate for Payer: HealthUtah PPO |
$8.79
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$8.53
|
| Rate for Payer: Multiplan Medicare/VA |
$4.76
|
| Rate for Payer: One Health Plan of WY PPO |
$8.61
|
| Rate for Payer: PacificSource Commercial |
$7.91
|
| Rate for Payer: PHCS PPO |
$8.61
|
| Rate for Payer: Three Rivers PPO |
$6.59
|
| Rate for Payer: TriWest Veterans Administration |
$5.01
|
| Rate for Payer: United Healthcare Commercial |
$8.39
|
| Rate for Payer: United Healthcare Medicare |
$5.01
|
| Rate for Payer: WINHealth Partners Commercial |
$8.61
|
| Rate for Payer: Wise Provider Network Commercial |
$8.35
|
|
|
CANNULA SHOEHORN AR-6565
|
Facility
|
OP
|
$87.50
|
|
| Hospital Charge Code |
3002026
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$47.38 |
| Max. Negotiated Rate |
$87.50 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$85.75
|
| Rate for Payer: Aetna of WY Medicare |
$57.75
|
| Rate for Payer: Altius Commercial |
$84.00
|
| Rate for Payer: Beech Street Commercial |
$85.75
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$84.88
|
| Rate for Payer: Cash Price |
$61.25
|
| Rate for Payer: ChoiceCare Network Commercial |
$84.88
|
| Rate for Payer: Cigna of WY Commercial |
$85.75
|
| Rate for Payer: Entrust Commercial |
$83.12
|
| Rate for Payer: First Choice Health Commercial |
$83.12
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$83.12
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$49.88
|
| Rate for Payer: HealthUtah PPO |
$87.50
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$84.88
|
| Rate for Payer: Multiplan Medicare/VA |
$47.38
|
| Rate for Payer: One Health Plan of WY PPO |
$85.75
|
| Rate for Payer: PacificSource Commercial |
$78.75
|
| Rate for Payer: PHCS PPO |
$85.75
|
| Rate for Payer: Three Rivers PPO |
$65.62
|
| Rate for Payer: TriWest Veterans Administration |
$49.88
|
| Rate for Payer: United Healthcare Commercial |
$83.56
|
| Rate for Payer: United Healthcare Medicare |
$49.88
|
| Rate for Payer: WINHealth Partners Commercial |
$85.75
|
| Rate for Payer: Wise Provider Network Commercial |
$83.12
|
|
|
CANNULA SHOEHORN AR-6565
|
Facility
|
IP
|
$87.50
|
|
| Hospital Charge Code |
3002026
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$50.71 |
| Max. Negotiated Rate |
$87.50 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$85.75
|
| Rate for Payer: Aetna of WY Medicare |
$56.00
|
| Rate for Payer: Altius Commercial |
$84.00
|
| Rate for Payer: Beech Street Commercial |
$85.75
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$84.88
|
| Rate for Payer: Cash Price |
$61.25
|
| Rate for Payer: ChoiceCare Network Commercial |
$84.88
|
| Rate for Payer: Cigna of WY Commercial |
$85.75
|
| Rate for Payer: Entrust Commercial |
$83.12
|
| Rate for Payer: First Choice Health Commercial |
$83.12
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$83.12
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$53.38
|
| Rate for Payer: HealthUtah PPO |
$87.50
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$84.88
|
| Rate for Payer: Multiplan Medicare/VA |
$50.71
|
| Rate for Payer: One Health Plan of WY PPO |
$85.75
|
| Rate for Payer: PacificSource Commercial |
$78.75
|
| Rate for Payer: PHCS PPO |
$85.75
|
| Rate for Payer: Three Rivers PPO |
$65.62
|
| Rate for Payer: TriWest Veterans Administration |
$53.38
|
| Rate for Payer: United Healthcare Commercial |
$83.56
|
| Rate for Payer: United Healthcare Medicare |
$53.38
|
| Rate for Payer: WINHealth Partners Commercial |
$83.12
|
| Rate for Payer: Wise Provider Network Commercial |
$83.12
|
|
|
CANNULATED SCREWDRIVER 2.0MM
|
Facility
|
IP
|
$602.00
|
|
| Hospital Charge Code |
3300160
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$348.86 |
| Max. Negotiated Rate |
$602.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$589.96
|
| Rate for Payer: Aetna of WY Medicare |
$385.28
|
| Rate for Payer: Altius Commercial |
$577.92
|
| Rate for Payer: Beech Street Commercial |
$589.96
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$583.94
|
| Rate for Payer: Cash Price |
$421.40
|
| Rate for Payer: ChoiceCare Network Commercial |
$583.94
|
| Rate for Payer: Cigna of WY Commercial |
$589.96
|
| Rate for Payer: Entrust Commercial |
$571.90
|
| Rate for Payer: First Choice Health Commercial |
$571.90
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$571.90
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$367.22
|
| Rate for Payer: HealthUtah PPO |
$602.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$583.94
|
| Rate for Payer: Multiplan Medicare/VA |
$348.86
|
| Rate for Payer: One Health Plan of WY PPO |
$589.96
|
| Rate for Payer: PacificSource Commercial |
$541.80
|
| Rate for Payer: PHCS PPO |
$589.96
|
| Rate for Payer: Three Rivers PPO |
$451.50
|
| Rate for Payer: TriWest Veterans Administration |
$367.22
|
| Rate for Payer: United Healthcare Commercial |
$574.91
|
| Rate for Payer: United Healthcare Medicare |
$367.22
|
| Rate for Payer: WINHealth Partners Commercial |
$571.90
|
| Rate for Payer: Wise Provider Network Commercial |
$571.90
|
|
|
CANNULATED SCREWDRIVER 2.0MM
|
Facility
|
OP
|
$602.00
|
|
| Hospital Charge Code |
3300160
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$325.98 |
| Max. Negotiated Rate |
$602.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$589.96
|
| Rate for Payer: Aetna of WY Medicare |
$397.32
|
| Rate for Payer: Altius Commercial |
$577.92
|
| Rate for Payer: Beech Street Commercial |
$589.96
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$583.94
|
| Rate for Payer: Cash Price |
$421.40
|
| Rate for Payer: ChoiceCare Network Commercial |
$583.94
|
| Rate for Payer: Cigna of WY Commercial |
$589.96
|
| Rate for Payer: Entrust Commercial |
$571.90
|
| Rate for Payer: First Choice Health Commercial |
$571.90
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$571.90
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$343.14
|
| Rate for Payer: HealthUtah PPO |
$602.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$583.94
|
| Rate for Payer: Multiplan Medicare/VA |
$325.98
|
| Rate for Payer: One Health Plan of WY PPO |
$589.96
|
| Rate for Payer: PacificSource Commercial |
$541.80
|
| Rate for Payer: PHCS PPO |
$589.96
|
| Rate for Payer: Three Rivers PPO |
$451.50
|
| Rate for Payer: TriWest Veterans Administration |
$343.14
|
| Rate for Payer: United Healthcare Commercial |
$574.91
|
| Rate for Payer: United Healthcare Medicare |
$343.14
|
| Rate for Payer: WINHealth Partners Commercial |
$589.96
|
| Rate for Payer: Wise Provider Network Commercial |
$571.90
|
|
|
CANNULA TRIM-IT CUSTOM HIP
|
Facility
|
IP
|
$227.50
|
|
| Hospital Charge Code |
3003275
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$131.84 |
| Max. Negotiated Rate |
$227.50 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$222.95
|
| Rate for Payer: Aetna of WY Medicare |
$145.60
|
| Rate for Payer: Altius Commercial |
$218.40
|
| Rate for Payer: Beech Street Commercial |
$222.95
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$220.68
|
| Rate for Payer: Cash Price |
$159.25
|
| Rate for Payer: ChoiceCare Network Commercial |
$220.68
|
| Rate for Payer: Cigna of WY Commercial |
$222.95
|
| Rate for Payer: Entrust Commercial |
$216.12
|
| Rate for Payer: First Choice Health Commercial |
$216.12
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$216.12
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$138.78
|
| Rate for Payer: HealthUtah PPO |
$227.50
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$220.68
|
| Rate for Payer: Multiplan Medicare/VA |
$131.84
|
| Rate for Payer: One Health Plan of WY PPO |
$222.95
|
| Rate for Payer: PacificSource Commercial |
$204.75
|
| Rate for Payer: PHCS PPO |
$222.95
|
| Rate for Payer: Three Rivers PPO |
$170.62
|
| Rate for Payer: TriWest Veterans Administration |
$138.78
|
| Rate for Payer: United Healthcare Commercial |
$217.26
|
| Rate for Payer: United Healthcare Medicare |
$138.78
|
| Rate for Payer: WINHealth Partners Commercial |
$216.12
|
| Rate for Payer: Wise Provider Network Commercial |
$216.12
|
|
|
CANNULA TRIM-IT CUSTOM HIP
|
Facility
|
OP
|
$227.50
|
|
| Hospital Charge Code |
3003275
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$123.19 |
| Max. Negotiated Rate |
$227.50 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$222.95
|
| Rate for Payer: Aetna of WY Medicare |
$150.15
|
| Rate for Payer: Altius Commercial |
$218.40
|
| Rate for Payer: Beech Street Commercial |
$222.95
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$220.68
|
| Rate for Payer: Cash Price |
$159.25
|
| Rate for Payer: ChoiceCare Network Commercial |
$220.68
|
| Rate for Payer: Cigna of WY Commercial |
$222.95
|
| Rate for Payer: Entrust Commercial |
$216.12
|
| Rate for Payer: First Choice Health Commercial |
$216.12
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$216.12
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$129.68
|
| Rate for Payer: HealthUtah PPO |
$227.50
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$220.68
|
| Rate for Payer: Multiplan Medicare/VA |
$123.19
|
| Rate for Payer: One Health Plan of WY PPO |
$222.95
|
| Rate for Payer: PacificSource Commercial |
$204.75
|
| Rate for Payer: PHCS PPO |
$222.95
|
| Rate for Payer: Three Rivers PPO |
$170.62
|
| Rate for Payer: TriWest Veterans Administration |
$129.68
|
| Rate for Payer: United Healthcare Commercial |
$217.26
|
| Rate for Payer: United Healthcare Medicare |
$129.68
|
| Rate for Payer: WINHealth Partners Commercial |
$222.95
|
| Rate for Payer: Wise Provider Network Commercial |
$216.12
|
|
|
CANNULA TWISTIN GOLD AR-6530
|
Facility
|
OP
|
$102.20
|
|
| Hospital Charge Code |
2650336
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$55.34 |
| Max. Negotiated Rate |
$102.20 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$100.16
|
| Rate for Payer: Aetna of WY Medicare |
$67.45
|
| Rate for Payer: Altius Commercial |
$98.11
|
| Rate for Payer: Beech Street Commercial |
$100.16
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$99.13
|
| Rate for Payer: Cash Price |
$71.54
|
| Rate for Payer: ChoiceCare Network Commercial |
$99.13
|
| Rate for Payer: Cigna of WY Commercial |
$100.16
|
| Rate for Payer: Entrust Commercial |
$97.09
|
| Rate for Payer: First Choice Health Commercial |
$97.09
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$97.09
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$58.25
|
| Rate for Payer: HealthUtah PPO |
$102.20
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$99.13
|
| Rate for Payer: Multiplan Medicare/VA |
$55.34
|
| Rate for Payer: One Health Plan of WY PPO |
$100.16
|
| Rate for Payer: PacificSource Commercial |
$91.98
|
| Rate for Payer: PHCS PPO |
$100.16
|
| Rate for Payer: Three Rivers PPO |
$76.65
|
| Rate for Payer: TriWest Veterans Administration |
$58.25
|
| Rate for Payer: United Healthcare Commercial |
$97.60
|
| Rate for Payer: United Healthcare Medicare |
$58.25
|
| Rate for Payer: WINHealth Partners Commercial |
$100.16
|
| Rate for Payer: Wise Provider Network Commercial |
$97.09
|
|
|
CANNULA TWISTIN GOLD AR-6530
|
Facility
|
IP
|
$102.20
|
|
| Hospital Charge Code |
2650336
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$59.22 |
| Max. Negotiated Rate |
$102.20 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$100.16
|
| Rate for Payer: Aetna of WY Medicare |
$65.41
|
| Rate for Payer: Altius Commercial |
$98.11
|
| Rate for Payer: Beech Street Commercial |
$100.16
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$99.13
|
| Rate for Payer: Cash Price |
$71.54
|
| Rate for Payer: ChoiceCare Network Commercial |
$99.13
|
| Rate for Payer: Cigna of WY Commercial |
$100.16
|
| Rate for Payer: Entrust Commercial |
$97.09
|
| Rate for Payer: First Choice Health Commercial |
$97.09
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$97.09
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$62.34
|
| Rate for Payer: HealthUtah PPO |
$102.20
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$99.13
|
| Rate for Payer: Multiplan Medicare/VA |
$59.22
|
| Rate for Payer: One Health Plan of WY PPO |
$100.16
|
| Rate for Payer: PacificSource Commercial |
$91.98
|
| Rate for Payer: PHCS PPO |
$100.16
|
| Rate for Payer: Three Rivers PPO |
$76.65
|
| Rate for Payer: TriWest Veterans Administration |
$62.34
|
| Rate for Payer: United Healthcare Commercial |
$97.60
|
| Rate for Payer: United Healthcare Medicare |
$62.34
|
| Rate for Payer: WINHealth Partners Commercial |
$97.09
|
| Rate for Payer: Wise Provider Network Commercial |
$97.09
|
|
|
CANNULA TWISTIN GREEN AR-6535
|
Facility
|
OP
|
$102.20
|
|
| Hospital Charge Code |
3000136
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$55.34 |
| Max. Negotiated Rate |
$102.20 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$100.16
|
| Rate for Payer: Aetna of WY Medicare |
$67.45
|
| Rate for Payer: Altius Commercial |
$98.11
|
| Rate for Payer: Beech Street Commercial |
$100.16
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$99.13
|
| Rate for Payer: Cash Price |
$71.54
|
| Rate for Payer: ChoiceCare Network Commercial |
$99.13
|
| Rate for Payer: Cigna of WY Commercial |
$100.16
|
| Rate for Payer: Entrust Commercial |
$97.09
|
| Rate for Payer: First Choice Health Commercial |
$97.09
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$97.09
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$58.25
|
| Rate for Payer: HealthUtah PPO |
$102.20
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$99.13
|
| Rate for Payer: Multiplan Medicare/VA |
$55.34
|
| Rate for Payer: One Health Plan of WY PPO |
$100.16
|
| Rate for Payer: PacificSource Commercial |
$91.98
|
| Rate for Payer: PHCS PPO |
$100.16
|
| Rate for Payer: Three Rivers PPO |
$76.65
|
| Rate for Payer: TriWest Veterans Administration |
$58.25
|
| Rate for Payer: United Healthcare Commercial |
$97.60
|
| Rate for Payer: United Healthcare Medicare |
$58.25
|
| Rate for Payer: WINHealth Partners Commercial |
$100.16
|
| Rate for Payer: Wise Provider Network Commercial |
$97.09
|
|
|
CANNULA TWISTIN GREEN AR-6535
|
Facility
|
IP
|
$102.20
|
|
| Hospital Charge Code |
3000136
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$59.22 |
| Max. Negotiated Rate |
$102.20 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$100.16
|
| Rate for Payer: Aetna of WY Medicare |
$65.41
|
| Rate for Payer: Altius Commercial |
$98.11
|
| Rate for Payer: Beech Street Commercial |
$100.16
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$99.13
|
| Rate for Payer: Cash Price |
$71.54
|
| Rate for Payer: ChoiceCare Network Commercial |
$99.13
|
| Rate for Payer: Cigna of WY Commercial |
$100.16
|
| Rate for Payer: Entrust Commercial |
$97.09
|
| Rate for Payer: First Choice Health Commercial |
$97.09
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$97.09
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$62.34
|
| Rate for Payer: HealthUtah PPO |
$102.20
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$99.13
|
| Rate for Payer: Multiplan Medicare/VA |
$59.22
|
| Rate for Payer: One Health Plan of WY PPO |
$100.16
|
| Rate for Payer: PacificSource Commercial |
$91.98
|
| Rate for Payer: PHCS PPO |
$100.16
|
| Rate for Payer: Three Rivers PPO |
$76.65
|
| Rate for Payer: TriWest Veterans Administration |
$62.34
|
| Rate for Payer: United Healthcare Commercial |
$97.60
|
| Rate for Payer: United Healthcare Medicare |
$62.34
|
| Rate for Payer: WINHealth Partners Commercial |
$97.09
|
| Rate for Payer: Wise Provider Network Commercial |
$97.09
|
|
|
CANNULA TWISTIN PURPLE AR-6570
|
Facility
|
IP
|
$102.20
|
|
| Hospital Charge Code |
2650164
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$59.22 |
| Max. Negotiated Rate |
$102.20 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$100.16
|
| Rate for Payer: Aetna of WY Medicare |
$65.41
|
| Rate for Payer: Altius Commercial |
$98.11
|
| Rate for Payer: Beech Street Commercial |
$100.16
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$99.13
|
| Rate for Payer: Cash Price |
$71.54
|
| Rate for Payer: ChoiceCare Network Commercial |
$99.13
|
| Rate for Payer: Cigna of WY Commercial |
$100.16
|
| Rate for Payer: Entrust Commercial |
$97.09
|
| Rate for Payer: First Choice Health Commercial |
$97.09
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$97.09
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$62.34
|
| Rate for Payer: HealthUtah PPO |
$102.20
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$99.13
|
| Rate for Payer: Multiplan Medicare/VA |
$59.22
|
| Rate for Payer: One Health Plan of WY PPO |
$100.16
|
| Rate for Payer: PacificSource Commercial |
$91.98
|
| Rate for Payer: PHCS PPO |
$100.16
|
| Rate for Payer: Three Rivers PPO |
$76.65
|
| Rate for Payer: TriWest Veterans Administration |
$62.34
|
| Rate for Payer: United Healthcare Commercial |
$97.60
|
| Rate for Payer: United Healthcare Medicare |
$62.34
|
| Rate for Payer: WINHealth Partners Commercial |
$97.09
|
| Rate for Payer: Wise Provider Network Commercial |
$97.09
|
|
|
CANNULA TWISTIN PURPLE AR-6570
|
Facility
|
OP
|
$102.20
|
|
| Hospital Charge Code |
2650164
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$55.34 |
| Max. Negotiated Rate |
$102.20 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$100.16
|
| Rate for Payer: Aetna of WY Medicare |
$67.45
|
| Rate for Payer: Altius Commercial |
$98.11
|
| Rate for Payer: Beech Street Commercial |
$100.16
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$99.13
|
| Rate for Payer: Cash Price |
$71.54
|
| Rate for Payer: ChoiceCare Network Commercial |
$99.13
|
| Rate for Payer: Cigna of WY Commercial |
$100.16
|
| Rate for Payer: Entrust Commercial |
$97.09
|
| Rate for Payer: First Choice Health Commercial |
$97.09
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$97.09
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$58.25
|
| Rate for Payer: HealthUtah PPO |
$102.20
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$99.13
|
| Rate for Payer: Multiplan Medicare/VA |
$55.34
|
| Rate for Payer: One Health Plan of WY PPO |
$100.16
|
| Rate for Payer: PacificSource Commercial |
$91.98
|
| Rate for Payer: PHCS PPO |
$100.16
|
| Rate for Payer: Three Rivers PPO |
$76.65
|
| Rate for Payer: TriWest Veterans Administration |
$58.25
|
| Rate for Payer: United Healthcare Commercial |
$97.60
|
| Rate for Payer: United Healthcare Medicare |
$58.25
|
| Rate for Payer: WINHealth Partners Commercial |
$100.16
|
| Rate for Payer: Wise Provider Network Commercial |
$97.09
|
|
|
CAPIO SLIM SUTURE CAPTURING DEVICE
|
Facility
|
IP
|
$2,109.31
|
|
| Hospital Charge Code |
2650994
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,222.35 |
| Max. Negotiated Rate |
$2,109.31 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,067.12
|
| Rate for Payer: Aetna of WY Medicare |
$1,349.96
|
| Rate for Payer: Altius Commercial |
$2,024.94
|
| Rate for Payer: Beech Street Commercial |
$2,067.12
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$2,046.03
|
| Rate for Payer: Cash Price |
$1,476.52
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,046.03
|
| Rate for Payer: Cigna of WY Commercial |
$2,067.12
|
| Rate for Payer: Entrust Commercial |
$2,003.84
|
| Rate for Payer: First Choice Health Commercial |
$2,003.84
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,003.84
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$1,286.68
|
| Rate for Payer: HealthUtah PPO |
$2,109.31
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,046.03
|
| Rate for Payer: Multiplan Medicare/VA |
$1,222.35
|
| Rate for Payer: One Health Plan of WY PPO |
$2,067.12
|
| Rate for Payer: PacificSource Commercial |
$1,898.38
|
| Rate for Payer: PHCS PPO |
$2,067.12
|
| Rate for Payer: Three Rivers PPO |
$1,581.98
|
| Rate for Payer: TriWest Veterans Administration |
$1,286.68
|
| Rate for Payer: United Healthcare Commercial |
$2,014.39
|
| Rate for Payer: United Healthcare Medicare |
$1,286.68
|
| Rate for Payer: WINHealth Partners Commercial |
$2,003.84
|
| Rate for Payer: Wise Provider Network Commercial |
$2,003.84
|
|
|
CAPIO SLIM SUTURE CAPTURING DEVICE
|
Facility
|
OP
|
$2,109.31
|
|
| Hospital Charge Code |
2650994
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,142.19 |
| Max. Negotiated Rate |
$2,109.31 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2,067.12
|
| Rate for Payer: Aetna of WY Medicare |
$1,392.14
|
| Rate for Payer: Altius Commercial |
$2,024.94
|
| Rate for Payer: Beech Street Commercial |
$2,067.12
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$2,046.03
|
| Rate for Payer: Cash Price |
$1,476.52
|
| Rate for Payer: ChoiceCare Network Commercial |
$2,046.03
|
| Rate for Payer: Cigna of WY Commercial |
$2,067.12
|
| Rate for Payer: Entrust Commercial |
$2,003.84
|
| Rate for Payer: First Choice Health Commercial |
$2,003.84
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2,003.84
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$1,202.31
|
| Rate for Payer: HealthUtah PPO |
$2,109.31
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2,046.03
|
| Rate for Payer: Multiplan Medicare/VA |
$1,142.19
|
| Rate for Payer: One Health Plan of WY PPO |
$2,067.12
|
| Rate for Payer: PacificSource Commercial |
$1,898.38
|
| Rate for Payer: PHCS PPO |
$2,067.12
|
| Rate for Payer: Three Rivers PPO |
$1,581.98
|
| Rate for Payer: TriWest Veterans Administration |
$1,202.31
|
| Rate for Payer: United Healthcare Commercial |
$2,014.39
|
| Rate for Payer: United Healthcare Medicare |
$1,202.31
|
| Rate for Payer: WINHealth Partners Commercial |
$2,067.12
|
| Rate for Payer: Wise Provider Network Commercial |
$2,003.84
|
|
|
CAPIO SUTURE NA BRAID 26MM 1/2 TAPER 36"
|
Facility
|
IP
|
$152.74
|
|
| Hospital Charge Code |
2650995
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$88.51 |
| Max. Negotiated Rate |
$152.74 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$149.69
|
| Rate for Payer: Aetna of WY Medicare |
$97.75
|
| Rate for Payer: Altius Commercial |
$146.63
|
| Rate for Payer: Beech Street Commercial |
$149.69
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$148.16
|
| Rate for Payer: Cash Price |
$106.92
|
| Rate for Payer: ChoiceCare Network Commercial |
$148.16
|
| Rate for Payer: Cigna of WY Commercial |
$149.69
|
| Rate for Payer: Entrust Commercial |
$145.10
|
| Rate for Payer: First Choice Health Commercial |
$145.10
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$145.10
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$93.17
|
| Rate for Payer: HealthUtah PPO |
$152.74
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$148.16
|
| Rate for Payer: Multiplan Medicare/VA |
$88.51
|
| Rate for Payer: One Health Plan of WY PPO |
$149.69
|
| Rate for Payer: PacificSource Commercial |
$137.47
|
| Rate for Payer: PHCS PPO |
$149.69
|
| Rate for Payer: Three Rivers PPO |
$114.56
|
| Rate for Payer: TriWest Veterans Administration |
$93.17
|
| Rate for Payer: United Healthcare Commercial |
$145.87
|
| Rate for Payer: United Healthcare Medicare |
$93.17
|
| Rate for Payer: WINHealth Partners Commercial |
$145.10
|
| Rate for Payer: Wise Provider Network Commercial |
$145.10
|
|
|
CAPIO SUTURE NA BRAID 26MM 1/2 TAPER 36"
|
Facility
|
OP
|
$152.74
|
|
| Hospital Charge Code |
2650995
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$82.71 |
| Max. Negotiated Rate |
$152.74 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$149.69
|
| Rate for Payer: Aetna of WY Medicare |
$100.81
|
| Rate for Payer: Altius Commercial |
$146.63
|
| Rate for Payer: Beech Street Commercial |
$149.69
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$148.16
|
| Rate for Payer: Cash Price |
$106.92
|
| Rate for Payer: ChoiceCare Network Commercial |
$148.16
|
| Rate for Payer: Cigna of WY Commercial |
$149.69
|
| Rate for Payer: Entrust Commercial |
$145.10
|
| Rate for Payer: First Choice Health Commercial |
$145.10
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$145.10
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$87.06
|
| Rate for Payer: HealthUtah PPO |
$152.74
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$148.16
|
| Rate for Payer: Multiplan Medicare/VA |
$82.71
|
| Rate for Payer: One Health Plan of WY PPO |
$149.69
|
| Rate for Payer: PacificSource Commercial |
$137.47
|
| Rate for Payer: PHCS PPO |
$149.69
|
| Rate for Payer: Three Rivers PPO |
$114.56
|
| Rate for Payer: TriWest Veterans Administration |
$87.06
|
| Rate for Payer: United Healthcare Commercial |
$145.87
|
| Rate for Payer: United Healthcare Medicare |
$87.06
|
| Rate for Payer: WINHealth Partners Commercial |
$149.69
|
| Rate for Payer: Wise Provider Network Commercial |
$145.10
|
|
|
CAPNOLINE CO2/O2 TUBING ADULT
|
Facility
|
IP
|
$30.37
|
|
| Hospital Charge Code |
2100036
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$17.60 |
| Max. Negotiated Rate |
$30.37 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$29.76
|
| Rate for Payer: Aetna of WY Medicare |
$19.44
|
| Rate for Payer: Altius Commercial |
$29.16
|
| Rate for Payer: Beech Street Commercial |
$29.76
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$29.46
|
| Rate for Payer: Cash Price |
$21.26
|
| Rate for Payer: ChoiceCare Network Commercial |
$29.46
|
| Rate for Payer: Cigna of WY Commercial |
$29.76
|
| Rate for Payer: Entrust Commercial |
$28.85
|
| Rate for Payer: First Choice Health Commercial |
$28.85
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$28.85
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$18.53
|
| Rate for Payer: HealthUtah PPO |
$30.37
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$29.46
|
| Rate for Payer: Multiplan Medicare/VA |
$17.60
|
| Rate for Payer: One Health Plan of WY PPO |
$29.76
|
| Rate for Payer: PacificSource Commercial |
$27.33
|
| Rate for Payer: PHCS PPO |
$29.76
|
| Rate for Payer: Three Rivers PPO |
$22.78
|
| Rate for Payer: TriWest Veterans Administration |
$18.53
|
| Rate for Payer: United Healthcare Commercial |
$29.00
|
| Rate for Payer: United Healthcare Medicare |
$18.53
|
| Rate for Payer: WINHealth Partners Commercial |
$28.85
|
| Rate for Payer: Wise Provider Network Commercial |
$28.85
|
|
|
CAPNOLINE CO2/O2 TUBING ADULT
|
Facility
|
OP
|
$30.37
|
|
| Hospital Charge Code |
2100036
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$16.45 |
| Max. Negotiated Rate |
$30.37 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$29.76
|
| Rate for Payer: Aetna of WY Medicare |
$20.04
|
| Rate for Payer: Altius Commercial |
$29.16
|
| Rate for Payer: Beech Street Commercial |
$29.76
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$29.46
|
| Rate for Payer: Cash Price |
$21.26
|
| Rate for Payer: ChoiceCare Network Commercial |
$29.46
|
| Rate for Payer: Cigna of WY Commercial |
$29.76
|
| Rate for Payer: Entrust Commercial |
$28.85
|
| Rate for Payer: First Choice Health Commercial |
$28.85
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$28.85
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$17.31
|
| Rate for Payer: HealthUtah PPO |
$30.37
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$29.46
|
| Rate for Payer: Multiplan Medicare/VA |
$16.45
|
| Rate for Payer: One Health Plan of WY PPO |
$29.76
|
| Rate for Payer: PacificSource Commercial |
$27.33
|
| Rate for Payer: PHCS PPO |
$29.76
|
| Rate for Payer: Three Rivers PPO |
$22.78
|
| Rate for Payer: TriWest Veterans Administration |
$17.31
|
| Rate for Payer: United Healthcare Commercial |
$29.00
|
| Rate for Payer: United Healthcare Medicare |
$17.31
|
| Rate for Payer: WINHealth Partners Commercial |
$29.76
|
| Rate for Payer: Wise Provider Network Commercial |
$28.85
|
|
|
CAPNOLINE CO2/O2 TUBING PEDS
|
Facility
|
IP
|
$36.85
|
|
| Hospital Charge Code |
2100037
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$21.35 |
| Max. Negotiated Rate |
$36.85 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$36.11
|
| Rate for Payer: Aetna of WY Medicare |
$23.58
|
| Rate for Payer: Altius Commercial |
$35.38
|
| Rate for Payer: Beech Street Commercial |
$36.11
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$35.74
|
| Rate for Payer: Cash Price |
$25.79
|
| Rate for Payer: ChoiceCare Network Commercial |
$35.74
|
| Rate for Payer: Cigna of WY Commercial |
$36.11
|
| Rate for Payer: Entrust Commercial |
$35.01
|
| Rate for Payer: First Choice Health Commercial |
$35.01
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$35.01
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$22.48
|
| Rate for Payer: HealthUtah PPO |
$36.85
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$35.74
|
| Rate for Payer: Multiplan Medicare/VA |
$21.35
|
| Rate for Payer: One Health Plan of WY PPO |
$36.11
|
| Rate for Payer: PacificSource Commercial |
$33.16
|
| Rate for Payer: PHCS PPO |
$36.11
|
| Rate for Payer: Three Rivers PPO |
$27.64
|
| Rate for Payer: TriWest Veterans Administration |
$22.48
|
| Rate for Payer: United Healthcare Commercial |
$35.19
|
| Rate for Payer: United Healthcare Medicare |
$22.48
|
| Rate for Payer: WINHealth Partners Commercial |
$35.01
|
| Rate for Payer: Wise Provider Network Commercial |
$35.01
|
|
|
CAPNOLINE CO2/O2 TUBING PEDS
|
Facility
|
OP
|
$36.85
|
|
| Hospital Charge Code |
2100037
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$19.95 |
| Max. Negotiated Rate |
$36.85 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$36.11
|
| Rate for Payer: Aetna of WY Medicare |
$24.32
|
| Rate for Payer: Altius Commercial |
$35.38
|
| Rate for Payer: Beech Street Commercial |
$36.11
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$35.74
|
| Rate for Payer: Cash Price |
$25.79
|
| Rate for Payer: ChoiceCare Network Commercial |
$35.74
|
| Rate for Payer: Cigna of WY Commercial |
$36.11
|
| Rate for Payer: Entrust Commercial |
$35.01
|
| Rate for Payer: First Choice Health Commercial |
$35.01
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$35.01
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$21.00
|
| Rate for Payer: HealthUtah PPO |
$36.85
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$35.74
|
| Rate for Payer: Multiplan Medicare/VA |
$19.95
|
| Rate for Payer: One Health Plan of WY PPO |
$36.11
|
| Rate for Payer: PacificSource Commercial |
$33.16
|
| Rate for Payer: PHCS PPO |
$36.11
|
| Rate for Payer: Three Rivers PPO |
$27.64
|
| Rate for Payer: TriWest Veterans Administration |
$21.00
|
| Rate for Payer: United Healthcare Commercial |
$35.19
|
| Rate for Payer: United Healthcare Medicare |
$21.00
|
| Rate for Payer: WINHealth Partners Commercial |
$36.11
|
| Rate for Payer: Wise Provider Network Commercial |
$35.01
|
|
|
CAPR BATTERY 15HR 2500-37TSC
|
Facility
|
IP
|
$1,360.98
|
|
| Hospital Charge Code |
2100153
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$788.69 |
| Max. Negotiated Rate |
$1,360.98 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,333.76
|
| Rate for Payer: Aetna of WY Medicare |
$871.03
|
| Rate for Payer: Altius Commercial |
$1,306.54
|
| Rate for Payer: Beech Street Commercial |
$1,333.76
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$1,320.15
|
| Rate for Payer: Cash Price |
$952.68
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,320.15
|
| Rate for Payer: Cigna of WY Commercial |
$1,333.76
|
| Rate for Payer: Entrust Commercial |
$1,292.93
|
| Rate for Payer: First Choice Health Commercial |
$1,292.93
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,292.93
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$830.20
|
| Rate for Payer: HealthUtah PPO |
$1,360.98
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,320.15
|
| Rate for Payer: Multiplan Medicare/VA |
$788.69
|
| Rate for Payer: One Health Plan of WY PPO |
$1,333.76
|
| Rate for Payer: PacificSource Commercial |
$1,224.88
|
| Rate for Payer: PHCS PPO |
$1,333.76
|
| Rate for Payer: Three Rivers PPO |
$1,020.74
|
| Rate for Payer: TriWest Veterans Administration |
$830.20
|
| Rate for Payer: United Healthcare Commercial |
$1,299.74
|
| Rate for Payer: United Healthcare Medicare |
$830.20
|
| Rate for Payer: WINHealth Partners Commercial |
$1,292.93
|
| Rate for Payer: Wise Provider Network Commercial |
$1,292.93
|
|
|
CAPR BATTERY 15HR 2500-37TSC
|
Facility
|
OP
|
$1,360.98
|
|
| Hospital Charge Code |
2100153
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$736.97 |
| Max. Negotiated Rate |
$1,360.98 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,333.76
|
| Rate for Payer: Aetna of WY Medicare |
$898.25
|
| Rate for Payer: Altius Commercial |
$1,306.54
|
| Rate for Payer: Beech Street Commercial |
$1,333.76
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$1,320.15
|
| Rate for Payer: Cash Price |
$952.68
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,320.15
|
| Rate for Payer: Cigna of WY Commercial |
$1,333.76
|
| Rate for Payer: Entrust Commercial |
$1,292.93
|
| Rate for Payer: First Choice Health Commercial |
$1,292.93
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,292.93
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$775.76
|
| Rate for Payer: HealthUtah PPO |
$1,360.98
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,320.15
|
| Rate for Payer: Multiplan Medicare/VA |
$736.97
|
| Rate for Payer: One Health Plan of WY PPO |
$1,333.76
|
| Rate for Payer: PacificSource Commercial |
$1,224.88
|
| Rate for Payer: PHCS PPO |
$1,333.76
|
| Rate for Payer: Three Rivers PPO |
$1,020.74
|
| Rate for Payer: TriWest Veterans Administration |
$775.76
|
| Rate for Payer: United Healthcare Commercial |
$1,299.74
|
| Rate for Payer: United Healthcare Medicare |
$775.76
|
| Rate for Payer: WINHealth Partners Commercial |
$1,333.76
|
| Rate for Payer: Wise Provider Network Commercial |
$1,292.93
|
|
|
CAPR FILTER CARTRIDGE 2167-10
|
Facility
|
OP
|
$1,021.62
|
|
| Hospital Charge Code |
2100146
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$553.21 |
| Max. Negotiated Rate |
$1,021.62 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,001.19
|
| Rate for Payer: Aetna of WY Medicare |
$674.27
|
| Rate for Payer: Altius Commercial |
$980.76
|
| Rate for Payer: Beech Street Commercial |
$1,001.19
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$990.97
|
| Rate for Payer: Cash Price |
$715.13
|
| Rate for Payer: ChoiceCare Network Commercial |
$990.97
|
| Rate for Payer: Cigna of WY Commercial |
$1,001.19
|
| Rate for Payer: Entrust Commercial |
$970.54
|
| Rate for Payer: First Choice Health Commercial |
$970.54
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$970.54
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$582.32
|
| Rate for Payer: HealthUtah PPO |
$1,021.62
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$990.97
|
| Rate for Payer: Multiplan Medicare/VA |
$553.21
|
| Rate for Payer: One Health Plan of WY PPO |
$1,001.19
|
| Rate for Payer: PacificSource Commercial |
$919.46
|
| Rate for Payer: PHCS PPO |
$1,001.19
|
| Rate for Payer: Three Rivers PPO |
$766.22
|
| Rate for Payer: TriWest Veterans Administration |
$582.32
|
| Rate for Payer: United Healthcare Commercial |
$975.65
|
| Rate for Payer: United Healthcare Medicare |
$582.32
|
| Rate for Payer: WINHealth Partners Commercial |
$1,001.19
|
| Rate for Payer: Wise Provider Network Commercial |
$970.54
|
|
