|
CAST LINER DELTA DRY 3 IN
|
Facility
|
OP
|
$13.07
|
|
| Hospital Charge Code |
2250111
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$7.08 |
| Max. Negotiated Rate |
$13.07 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$12.81
|
| Rate for Payer: Aetna of WY Medicare |
$8.63
|
| Rate for Payer: Altius Commercial |
$12.55
|
| Rate for Payer: Beech Street Commercial |
$12.81
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$12.68
|
| Rate for Payer: Cash Price |
$9.15
|
| Rate for Payer: ChoiceCare Network Commercial |
$12.68
|
| Rate for Payer: Cigna of WY Commercial |
$12.81
|
| Rate for Payer: Entrust Commercial |
$12.42
|
| Rate for Payer: First Choice Health Commercial |
$12.42
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$12.42
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$7.45
|
| Rate for Payer: HealthUtah PPO |
$13.07
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$12.68
|
| Rate for Payer: Multiplan Medicare/VA |
$7.08
|
| Rate for Payer: One Health Plan of WY PPO |
$12.81
|
| Rate for Payer: PacificSource Commercial |
$11.76
|
| Rate for Payer: PHCS PPO |
$12.81
|
| Rate for Payer: Three Rivers PPO |
$9.80
|
| Rate for Payer: TriWest Veterans Administration |
$7.45
|
| Rate for Payer: United Healthcare Commercial |
$12.48
|
| Rate for Payer: United Healthcare Medicare |
$7.45
|
| Rate for Payer: WINHealth Partners Commercial |
$12.81
|
| Rate for Payer: Wise Provider Network Commercial |
$12.42
|
|
|
CAST LINER DELTA DRY 3 IN
|
Facility
|
IP
|
$13.07
|
|
| Hospital Charge Code |
2250111
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$7.57 |
| Max. Negotiated Rate |
$13.07 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$12.81
|
| Rate for Payer: Aetna of WY Medicare |
$8.36
|
| Rate for Payer: Altius Commercial |
$12.55
|
| Rate for Payer: Beech Street Commercial |
$12.81
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$12.68
|
| Rate for Payer: Cash Price |
$9.15
|
| Rate for Payer: ChoiceCare Network Commercial |
$12.68
|
| Rate for Payer: Cigna of WY Commercial |
$12.81
|
| Rate for Payer: Entrust Commercial |
$12.42
|
| Rate for Payer: First Choice Health Commercial |
$12.42
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$12.42
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$7.97
|
| Rate for Payer: HealthUtah PPO |
$13.07
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$12.68
|
| Rate for Payer: Multiplan Medicare/VA |
$7.57
|
| Rate for Payer: One Health Plan of WY PPO |
$12.81
|
| Rate for Payer: PacificSource Commercial |
$11.76
|
| Rate for Payer: PHCS PPO |
$12.81
|
| Rate for Payer: Three Rivers PPO |
$9.80
|
| Rate for Payer: TriWest Veterans Administration |
$7.97
|
| Rate for Payer: United Healthcare Commercial |
$12.48
|
| Rate for Payer: United Healthcare Medicare |
$7.97
|
| Rate for Payer: WINHealth Partners Commercial |
$12.42
|
| Rate for Payer: Wise Provider Network Commercial |
$12.42
|
|
|
CAST LINER DELTA DRY 4 IN
|
Facility
|
OP
|
$15.48
|
|
| Hospital Charge Code |
2250112
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$8.38 |
| Max. Negotiated Rate |
$15.48 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$15.17
|
| Rate for Payer: Aetna of WY Medicare |
$10.22
|
| Rate for Payer: Altius Commercial |
$14.86
|
| Rate for Payer: Beech Street Commercial |
$15.17
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$15.02
|
| Rate for Payer: Cash Price |
$10.84
|
| Rate for Payer: ChoiceCare Network Commercial |
$15.02
|
| Rate for Payer: Cigna of WY Commercial |
$15.17
|
| Rate for Payer: Entrust Commercial |
$14.71
|
| Rate for Payer: First Choice Health Commercial |
$14.71
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$14.71
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$8.82
|
| Rate for Payer: HealthUtah PPO |
$15.48
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$15.02
|
| Rate for Payer: Multiplan Medicare/VA |
$8.38
|
| Rate for Payer: One Health Plan of WY PPO |
$15.17
|
| Rate for Payer: PacificSource Commercial |
$13.93
|
| Rate for Payer: PHCS PPO |
$15.17
|
| Rate for Payer: Three Rivers PPO |
$11.61
|
| Rate for Payer: TriWest Veterans Administration |
$8.82
|
| Rate for Payer: United Healthcare Commercial |
$14.78
|
| Rate for Payer: United Healthcare Medicare |
$8.82
|
| Rate for Payer: WINHealth Partners Commercial |
$15.17
|
| Rate for Payer: Wise Provider Network Commercial |
$14.71
|
|
|
CAST LINER DELTA DRY 4 IN
|
Facility
|
IP
|
$15.48
|
|
| Hospital Charge Code |
2250112
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$8.97 |
| Max. Negotiated Rate |
$15.48 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$15.17
|
| Rate for Payer: Aetna of WY Medicare |
$9.91
|
| Rate for Payer: Altius Commercial |
$14.86
|
| Rate for Payer: Beech Street Commercial |
$15.17
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$15.02
|
| Rate for Payer: Cash Price |
$10.84
|
| Rate for Payer: ChoiceCare Network Commercial |
$15.02
|
| Rate for Payer: Cigna of WY Commercial |
$15.17
|
| Rate for Payer: Entrust Commercial |
$14.71
|
| Rate for Payer: First Choice Health Commercial |
$14.71
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$14.71
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$9.44
|
| Rate for Payer: HealthUtah PPO |
$15.48
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$15.02
|
| Rate for Payer: Multiplan Medicare/VA |
$8.97
|
| Rate for Payer: One Health Plan of WY PPO |
$15.17
|
| Rate for Payer: PacificSource Commercial |
$13.93
|
| Rate for Payer: PHCS PPO |
$15.17
|
| Rate for Payer: Three Rivers PPO |
$11.61
|
| Rate for Payer: TriWest Veterans Administration |
$9.44
|
| Rate for Payer: United Healthcare Commercial |
$14.78
|
| Rate for Payer: United Healthcare Medicare |
$9.44
|
| Rate for Payer: WINHealth Partners Commercial |
$14.71
|
| Rate for Payer: Wise Provider Network Commercial |
$14.71
|
|
|
CASTOR OIL 100 % ORAL [43747]
|
Facility
|
OP
|
$15.08
|
|
|
Service Code
|
NDC 2438551530
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$8.17 |
| Max. Negotiated Rate |
$15.08 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$14.78
|
| Rate for Payer: Aetna of WY Medicare |
$9.95
|
| Rate for Payer: Altius Commercial |
$14.48
|
| Rate for Payer: Beech Street Commercial |
$14.78
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$14.63
|
| Rate for Payer: Cash Price |
$10.56
|
| Rate for Payer: ChoiceCare Network Commercial |
$14.63
|
| Rate for Payer: Cigna of WY Commercial |
$14.78
|
| Rate for Payer: Entrust Commercial |
$14.33
|
| Rate for Payer: First Choice Health Commercial |
$14.33
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$14.33
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$8.60
|
| Rate for Payer: HealthUtah PPO |
$15.08
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$14.63
|
| Rate for Payer: Multiplan Medicare/VA |
$8.17
|
| Rate for Payer: One Health Plan of WY PPO |
$14.78
|
| Rate for Payer: PacificSource Commercial |
$13.57
|
| Rate for Payer: PHCS PPO |
$14.78
|
| Rate for Payer: Three Rivers PPO |
$11.31
|
| Rate for Payer: TriWest Veterans Administration |
$8.60
|
| Rate for Payer: United Healthcare Commercial |
$14.40
|
| Rate for Payer: United Healthcare Medicare |
$8.60
|
| Rate for Payer: WINHealth Partners Commercial |
$14.78
|
| Rate for Payer: Wise Provider Network Commercial |
$14.33
|
|
|
CASTOR OIL 100 % ORAL [43747]
|
Facility
|
IP
|
$15.08
|
|
|
Service Code
|
NDC 8770140068
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$8.74 |
| Max. Negotiated Rate |
$15.08 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$14.78
|
| Rate for Payer: Aetna of WY Medicare |
$9.65
|
| Rate for Payer: Altius Commercial |
$14.48
|
| Rate for Payer: Beech Street Commercial |
$14.78
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$14.63
|
| Rate for Payer: Cash Price |
$10.56
|
| Rate for Payer: ChoiceCare Network Commercial |
$14.63
|
| Rate for Payer: Cigna of WY Commercial |
$14.78
|
| Rate for Payer: Entrust Commercial |
$14.33
|
| Rate for Payer: First Choice Health Commercial |
$14.33
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$14.33
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$9.20
|
| Rate for Payer: HealthUtah PPO |
$15.08
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$14.63
|
| Rate for Payer: Multiplan Medicare/VA |
$8.74
|
| Rate for Payer: One Health Plan of WY PPO |
$14.78
|
| Rate for Payer: PacificSource Commercial |
$13.57
|
| Rate for Payer: PHCS PPO |
$14.78
|
| Rate for Payer: Three Rivers PPO |
$11.31
|
| Rate for Payer: TriWest Veterans Administration |
$9.20
|
| Rate for Payer: United Healthcare Commercial |
$14.40
|
| Rate for Payer: United Healthcare Medicare |
$9.20
|
| Rate for Payer: WINHealth Partners Commercial |
$14.33
|
| Rate for Payer: Wise Provider Network Commercial |
$14.33
|
|
|
CASTOR OIL 100 % ORAL [43747]
|
Facility
|
OP
|
$15.08
|
|
|
Service Code
|
NDC 8770140068
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$8.17 |
| Max. Negotiated Rate |
$15.08 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$14.78
|
| Rate for Payer: Aetna of WY Medicare |
$9.95
|
| Rate for Payer: Altius Commercial |
$14.48
|
| Rate for Payer: Beech Street Commercial |
$14.78
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$14.63
|
| Rate for Payer: Cash Price |
$10.56
|
| Rate for Payer: ChoiceCare Network Commercial |
$14.63
|
| Rate for Payer: Cigna of WY Commercial |
$14.78
|
| Rate for Payer: Entrust Commercial |
$14.33
|
| Rate for Payer: First Choice Health Commercial |
$14.33
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$14.33
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$8.60
|
| Rate for Payer: HealthUtah PPO |
$15.08
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$14.63
|
| Rate for Payer: Multiplan Medicare/VA |
$8.17
|
| Rate for Payer: One Health Plan of WY PPO |
$14.78
|
| Rate for Payer: PacificSource Commercial |
$13.57
|
| Rate for Payer: PHCS PPO |
$14.78
|
| Rate for Payer: Three Rivers PPO |
$11.31
|
| Rate for Payer: TriWest Veterans Administration |
$8.60
|
| Rate for Payer: United Healthcare Commercial |
$14.40
|
| Rate for Payer: United Healthcare Medicare |
$8.60
|
| Rate for Payer: WINHealth Partners Commercial |
$14.78
|
| Rate for Payer: Wise Provider Network Commercial |
$14.33
|
|
|
CASTOR OIL 100 % ORAL [43747]
|
Facility
|
IP
|
$15.08
|
|
|
Service Code
|
NDC 2438551530
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$8.74 |
| Max. Negotiated Rate |
$15.08 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$14.78
|
| Rate for Payer: Aetna of WY Medicare |
$9.65
|
| Rate for Payer: Altius Commercial |
$14.48
|
| Rate for Payer: Beech Street Commercial |
$14.78
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$14.63
|
| Rate for Payer: Cash Price |
$10.56
|
| Rate for Payer: ChoiceCare Network Commercial |
$14.63
|
| Rate for Payer: Cigna of WY Commercial |
$14.78
|
| Rate for Payer: Entrust Commercial |
$14.33
|
| Rate for Payer: First Choice Health Commercial |
$14.33
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$14.33
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$9.20
|
| Rate for Payer: HealthUtah PPO |
$15.08
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$14.63
|
| Rate for Payer: Multiplan Medicare/VA |
$8.74
|
| Rate for Payer: One Health Plan of WY PPO |
$14.78
|
| Rate for Payer: PacificSource Commercial |
$13.57
|
| Rate for Payer: PHCS PPO |
$14.78
|
| Rate for Payer: Three Rivers PPO |
$11.31
|
| Rate for Payer: TriWest Veterans Administration |
$9.20
|
| Rate for Payer: United Healthcare Commercial |
$14.40
|
| Rate for Payer: United Healthcare Medicare |
$9.20
|
| Rate for Payer: WINHealth Partners Commercial |
$14.33
|
| Rate for Payer: Wise Provider Network Commercial |
$14.33
|
|
|
CAST PAD 2" SPECIALIST 100
|
Facility
|
IP
|
$1.39
|
|
| Hospital Charge Code |
2250109
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.81 |
| Max. Negotiated Rate |
$1.39 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1.36
|
| Rate for Payer: Aetna of WY Medicare |
$0.89
|
| Rate for Payer: Altius Commercial |
$1.33
|
| Rate for Payer: Beech Street Commercial |
$1.36
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$1.35
|
| Rate for Payer: Cash Price |
$0.98
|
| Rate for Payer: ChoiceCare Network Commercial |
$1.35
|
| Rate for Payer: Cigna of WY Commercial |
$1.36
|
| Rate for Payer: Entrust Commercial |
$1.32
|
| Rate for Payer: First Choice Health Commercial |
$1.32
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1.32
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$0.85
|
| Rate for Payer: HealthUtah PPO |
$1.39
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1.35
|
| Rate for Payer: Multiplan Medicare/VA |
$0.81
|
| Rate for Payer: One Health Plan of WY PPO |
$1.36
|
| Rate for Payer: PacificSource Commercial |
$1.25
|
| Rate for Payer: PHCS PPO |
$1.36
|
| Rate for Payer: Three Rivers PPO |
$1.04
|
| Rate for Payer: TriWest Veterans Administration |
$0.85
|
| Rate for Payer: United Healthcare Commercial |
$1.33
|
| Rate for Payer: United Healthcare Medicare |
$0.85
|
| Rate for Payer: WINHealth Partners Commercial |
$1.32
|
| Rate for Payer: Wise Provider Network Commercial |
$1.32
|
|
|
CAST PAD 2" SPECIALIST 100
|
Facility
|
OP
|
$1.39
|
|
| Hospital Charge Code |
2250109
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.75 |
| Max. Negotiated Rate |
$1.39 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1.36
|
| Rate for Payer: Aetna of WY Medicare |
$0.92
|
| Rate for Payer: Altius Commercial |
$1.33
|
| Rate for Payer: Beech Street Commercial |
$1.36
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$1.35
|
| Rate for Payer: Cash Price |
$0.98
|
| Rate for Payer: ChoiceCare Network Commercial |
$1.35
|
| Rate for Payer: Cigna of WY Commercial |
$1.36
|
| Rate for Payer: Entrust Commercial |
$1.32
|
| Rate for Payer: First Choice Health Commercial |
$1.32
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1.32
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$0.79
|
| Rate for Payer: HealthUtah PPO |
$1.39
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1.35
|
| Rate for Payer: Multiplan Medicare/VA |
$0.75
|
| Rate for Payer: One Health Plan of WY PPO |
$1.36
|
| Rate for Payer: PacificSource Commercial |
$1.25
|
| Rate for Payer: PHCS PPO |
$1.36
|
| Rate for Payer: Three Rivers PPO |
$1.04
|
| Rate for Payer: TriWest Veterans Administration |
$0.79
|
| Rate for Payer: United Healthcare Commercial |
$1.33
|
| Rate for Payer: United Healthcare Medicare |
$0.79
|
| Rate for Payer: WINHealth Partners Commercial |
$1.36
|
| Rate for Payer: Wise Provider Network Commercial |
$1.32
|
|
|
CAST PAD 2" STERILE SPECIALIST
|
Facility
|
OP
|
$2.52
|
|
| Hospital Charge Code |
2250119
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.36 |
| Max. Negotiated Rate |
$2.52 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2.47
|
| Rate for Payer: Aetna of WY Medicare |
$1.66
|
| Rate for Payer: Altius Commercial |
$2.42
|
| Rate for Payer: Beech Street Commercial |
$2.47
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$2.44
|
| Rate for Payer: Cash Price |
$1.77
|
| Rate for Payer: ChoiceCare Network Commercial |
$2.44
|
| Rate for Payer: Cigna of WY Commercial |
$2.47
|
| Rate for Payer: Entrust Commercial |
$2.39
|
| Rate for Payer: First Choice Health Commercial |
$2.39
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2.39
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$1.44
|
| Rate for Payer: HealthUtah PPO |
$2.52
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2.44
|
| Rate for Payer: Multiplan Medicare/VA |
$1.36
|
| Rate for Payer: One Health Plan of WY PPO |
$2.47
|
| Rate for Payer: PacificSource Commercial |
$2.27
|
| Rate for Payer: PHCS PPO |
$2.47
|
| Rate for Payer: Three Rivers PPO |
$1.89
|
| Rate for Payer: TriWest Veterans Administration |
$1.44
|
| Rate for Payer: United Healthcare Commercial |
$2.41
|
| Rate for Payer: United Healthcare Medicare |
$1.44
|
| Rate for Payer: WINHealth Partners Commercial |
$2.47
|
| Rate for Payer: Wise Provider Network Commercial |
$2.39
|
|
|
CAST PAD 2" STERILE SPECIALIST
|
Facility
|
IP
|
$2.52
|
|
| Hospital Charge Code |
2250119
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.46 |
| Max. Negotiated Rate |
$2.52 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2.47
|
| Rate for Payer: Aetna of WY Medicare |
$1.61
|
| Rate for Payer: Altius Commercial |
$2.42
|
| Rate for Payer: Beech Street Commercial |
$2.47
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$2.44
|
| Rate for Payer: Cash Price |
$1.77
|
| Rate for Payer: ChoiceCare Network Commercial |
$2.44
|
| Rate for Payer: Cigna of WY Commercial |
$2.47
|
| Rate for Payer: Entrust Commercial |
$2.39
|
| Rate for Payer: First Choice Health Commercial |
$2.39
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2.39
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$1.54
|
| Rate for Payer: HealthUtah PPO |
$2.52
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2.44
|
| Rate for Payer: Multiplan Medicare/VA |
$1.46
|
| Rate for Payer: One Health Plan of WY PPO |
$2.47
|
| Rate for Payer: PacificSource Commercial |
$2.27
|
| Rate for Payer: PHCS PPO |
$2.47
|
| Rate for Payer: Three Rivers PPO |
$1.89
|
| Rate for Payer: TriWest Veterans Administration |
$1.54
|
| Rate for Payer: United Healthcare Commercial |
$2.41
|
| Rate for Payer: United Healthcare Medicare |
$1.54
|
| Rate for Payer: WINHealth Partners Commercial |
$2.39
|
| Rate for Payer: Wise Provider Network Commercial |
$2.39
|
|
|
CAST PAD 2" SYNTHETIC
|
Facility
|
IP
|
$1.35
|
|
| Hospital Charge Code |
2250115
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.78 |
| Max. Negotiated Rate |
$1.35 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1.32
|
| Rate for Payer: Aetna of WY Medicare |
$0.86
|
| Rate for Payer: Altius Commercial |
$1.30
|
| Rate for Payer: Beech Street Commercial |
$1.32
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$1.31
|
| Rate for Payer: Cash Price |
$0.94
|
| Rate for Payer: ChoiceCare Network Commercial |
$1.31
|
| Rate for Payer: Cigna of WY Commercial |
$1.32
|
| Rate for Payer: Entrust Commercial |
$1.28
|
| Rate for Payer: First Choice Health Commercial |
$1.28
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1.28
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$0.82
|
| Rate for Payer: HealthUtah PPO |
$1.35
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1.31
|
| Rate for Payer: Multiplan Medicare/VA |
$0.78
|
| Rate for Payer: One Health Plan of WY PPO |
$1.32
|
| Rate for Payer: PacificSource Commercial |
$1.22
|
| Rate for Payer: PHCS PPO |
$1.32
|
| Rate for Payer: Three Rivers PPO |
$1.01
|
| Rate for Payer: TriWest Veterans Administration |
$0.82
|
| Rate for Payer: United Healthcare Commercial |
$1.29
|
| Rate for Payer: United Healthcare Medicare |
$0.82
|
| Rate for Payer: WINHealth Partners Commercial |
$1.28
|
| Rate for Payer: Wise Provider Network Commercial |
$1.28
|
|
|
CAST PAD 2" SYNTHETIC
|
Facility
|
OP
|
$1.35
|
|
| Hospital Charge Code |
2250115
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.73 |
| Max. Negotiated Rate |
$1.35 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1.32
|
| Rate for Payer: Aetna of WY Medicare |
$0.89
|
| Rate for Payer: Altius Commercial |
$1.30
|
| Rate for Payer: Beech Street Commercial |
$1.32
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$1.31
|
| Rate for Payer: Cash Price |
$0.94
|
| Rate for Payer: ChoiceCare Network Commercial |
$1.31
|
| Rate for Payer: Cigna of WY Commercial |
$1.32
|
| Rate for Payer: Entrust Commercial |
$1.28
|
| Rate for Payer: First Choice Health Commercial |
$1.28
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1.28
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$0.77
|
| Rate for Payer: HealthUtah PPO |
$1.35
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1.31
|
| Rate for Payer: Multiplan Medicare/VA |
$0.73
|
| Rate for Payer: One Health Plan of WY PPO |
$1.32
|
| Rate for Payer: PacificSource Commercial |
$1.22
|
| Rate for Payer: PHCS PPO |
$1.32
|
| Rate for Payer: Three Rivers PPO |
$1.01
|
| Rate for Payer: TriWest Veterans Administration |
$0.77
|
| Rate for Payer: United Healthcare Commercial |
$1.29
|
| Rate for Payer: United Healthcare Medicare |
$0.77
|
| Rate for Payer: WINHealth Partners Commercial |
$1.32
|
| Rate for Payer: Wise Provider Network Commercial |
$1.28
|
|
|
CAST PAD 3" SPECIALIST
|
Facility
|
OP
|
$1.85
|
|
| Hospital Charge Code |
2250004
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$1.85 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1.81
|
| Rate for Payer: Aetna of WY Medicare |
$1.22
|
| Rate for Payer: Altius Commercial |
$1.78
|
| Rate for Payer: Beech Street Commercial |
$1.81
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$1.79
|
| Rate for Payer: Cash Price |
$1.30
|
| Rate for Payer: ChoiceCare Network Commercial |
$1.79
|
| Rate for Payer: Cigna of WY Commercial |
$1.81
|
| Rate for Payer: Entrust Commercial |
$1.76
|
| Rate for Payer: First Choice Health Commercial |
$1.76
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1.76
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$1.05
|
| Rate for Payer: HealthUtah PPO |
$1.85
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1.79
|
| Rate for Payer: Multiplan Medicare/VA |
$1.00
|
| Rate for Payer: One Health Plan of WY PPO |
$1.81
|
| Rate for Payer: PacificSource Commercial |
$1.66
|
| Rate for Payer: PHCS PPO |
$1.81
|
| Rate for Payer: Three Rivers PPO |
$1.39
|
| Rate for Payer: TriWest Veterans Administration |
$1.05
|
| Rate for Payer: United Healthcare Commercial |
$1.77
|
| Rate for Payer: United Healthcare Medicare |
$1.05
|
| Rate for Payer: WINHealth Partners Commercial |
$1.81
|
| Rate for Payer: Wise Provider Network Commercial |
$1.76
|
|
|
CAST PAD 3" SPECIALIST
|
Facility
|
IP
|
$1.85
|
|
| Hospital Charge Code |
2250004
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.07 |
| Max. Negotiated Rate |
$1.85 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1.81
|
| Rate for Payer: Aetna of WY Medicare |
$1.18
|
| Rate for Payer: Altius Commercial |
$1.78
|
| Rate for Payer: Beech Street Commercial |
$1.81
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$1.79
|
| Rate for Payer: Cash Price |
$1.30
|
| Rate for Payer: ChoiceCare Network Commercial |
$1.79
|
| Rate for Payer: Cigna of WY Commercial |
$1.81
|
| Rate for Payer: Entrust Commercial |
$1.76
|
| Rate for Payer: First Choice Health Commercial |
$1.76
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1.76
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$1.13
|
| Rate for Payer: HealthUtah PPO |
$1.85
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1.79
|
| Rate for Payer: Multiplan Medicare/VA |
$1.07
|
| Rate for Payer: One Health Plan of WY PPO |
$1.81
|
| Rate for Payer: PacificSource Commercial |
$1.66
|
| Rate for Payer: PHCS PPO |
$1.81
|
| Rate for Payer: Three Rivers PPO |
$1.39
|
| Rate for Payer: TriWest Veterans Administration |
$1.13
|
| Rate for Payer: United Healthcare Commercial |
$1.77
|
| Rate for Payer: United Healthcare Medicare |
$1.13
|
| Rate for Payer: WINHealth Partners Commercial |
$1.76
|
| Rate for Payer: Wise Provider Network Commercial |
$1.76
|
|
|
CAST PAD 3" STERILE SPECIALIST
|
Facility
|
OP
|
$3.36
|
|
| Hospital Charge Code |
2250120
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.82 |
| Max. Negotiated Rate |
$3.36 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3.29
|
| Rate for Payer: Aetna of WY Medicare |
$2.22
|
| Rate for Payer: Altius Commercial |
$3.23
|
| Rate for Payer: Beech Street Commercial |
$3.29
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$3.26
|
| Rate for Payer: Cash Price |
$2.35
|
| Rate for Payer: ChoiceCare Network Commercial |
$3.26
|
| Rate for Payer: Cigna of WY Commercial |
$3.29
|
| Rate for Payer: Entrust Commercial |
$3.19
|
| Rate for Payer: First Choice Health Commercial |
$3.19
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3.19
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$1.92
|
| Rate for Payer: HealthUtah PPO |
$3.36
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3.26
|
| Rate for Payer: Multiplan Medicare/VA |
$1.82
|
| Rate for Payer: One Health Plan of WY PPO |
$3.29
|
| Rate for Payer: PacificSource Commercial |
$3.02
|
| Rate for Payer: PHCS PPO |
$3.29
|
| Rate for Payer: Three Rivers PPO |
$2.52
|
| Rate for Payer: TriWest Veterans Administration |
$1.92
|
| Rate for Payer: United Healthcare Commercial |
$3.21
|
| Rate for Payer: United Healthcare Medicare |
$1.92
|
| Rate for Payer: WINHealth Partners Commercial |
$3.29
|
| Rate for Payer: Wise Provider Network Commercial |
$3.19
|
|
|
CAST PAD 3" STERILE SPECIALIST
|
Facility
|
IP
|
$3.36
|
|
| Hospital Charge Code |
2250120
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.95 |
| Max. Negotiated Rate |
$3.36 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3.29
|
| Rate for Payer: Aetna of WY Medicare |
$2.15
|
| Rate for Payer: Altius Commercial |
$3.23
|
| Rate for Payer: Beech Street Commercial |
$3.29
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$3.26
|
| Rate for Payer: Cash Price |
$2.35
|
| Rate for Payer: ChoiceCare Network Commercial |
$3.26
|
| Rate for Payer: Cigna of WY Commercial |
$3.29
|
| Rate for Payer: Entrust Commercial |
$3.19
|
| Rate for Payer: First Choice Health Commercial |
$3.19
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3.19
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$2.05
|
| Rate for Payer: HealthUtah PPO |
$3.36
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3.26
|
| Rate for Payer: Multiplan Medicare/VA |
$1.95
|
| Rate for Payer: One Health Plan of WY PPO |
$3.29
|
| Rate for Payer: PacificSource Commercial |
$3.02
|
| Rate for Payer: PHCS PPO |
$3.29
|
| Rate for Payer: Three Rivers PPO |
$2.52
|
| Rate for Payer: TriWest Veterans Administration |
$2.05
|
| Rate for Payer: United Healthcare Commercial |
$3.21
|
| Rate for Payer: United Healthcare Medicare |
$2.05
|
| Rate for Payer: WINHealth Partners Commercial |
$3.19
|
| Rate for Payer: Wise Provider Network Commercial |
$3.19
|
|
|
CAST PAD 3" SYNTHETIC
|
Facility
|
OP
|
$1.95
|
|
| Hospital Charge Code |
2250116
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.06 |
| Max. Negotiated Rate |
$1.95 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1.91
|
| Rate for Payer: Aetna of WY Medicare |
$1.29
|
| Rate for Payer: Altius Commercial |
$1.87
|
| Rate for Payer: Beech Street Commercial |
$1.91
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$1.89
|
| Rate for Payer: Cash Price |
$1.37
|
| Rate for Payer: ChoiceCare Network Commercial |
$1.89
|
| Rate for Payer: Cigna of WY Commercial |
$1.91
|
| Rate for Payer: Entrust Commercial |
$1.85
|
| Rate for Payer: First Choice Health Commercial |
$1.85
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1.85
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$1.11
|
| Rate for Payer: HealthUtah PPO |
$1.95
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1.89
|
| Rate for Payer: Multiplan Medicare/VA |
$1.06
|
| Rate for Payer: One Health Plan of WY PPO |
$1.91
|
| Rate for Payer: PacificSource Commercial |
$1.76
|
| Rate for Payer: PHCS PPO |
$1.91
|
| Rate for Payer: Three Rivers PPO |
$1.46
|
| Rate for Payer: TriWest Veterans Administration |
$1.11
|
| Rate for Payer: United Healthcare Commercial |
$1.86
|
| Rate for Payer: United Healthcare Medicare |
$1.11
|
| Rate for Payer: WINHealth Partners Commercial |
$1.91
|
| Rate for Payer: Wise Provider Network Commercial |
$1.85
|
|
|
CAST PAD 3" SYNTHETIC
|
Facility
|
IP
|
$1.95
|
|
| Hospital Charge Code |
2250116
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.13 |
| Max. Negotiated Rate |
$1.95 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1.91
|
| Rate for Payer: Aetna of WY Medicare |
$1.25
|
| Rate for Payer: Altius Commercial |
$1.87
|
| Rate for Payer: Beech Street Commercial |
$1.91
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$1.89
|
| Rate for Payer: Cash Price |
$1.37
|
| Rate for Payer: ChoiceCare Network Commercial |
$1.89
|
| Rate for Payer: Cigna of WY Commercial |
$1.91
|
| Rate for Payer: Entrust Commercial |
$1.85
|
| Rate for Payer: First Choice Health Commercial |
$1.85
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1.85
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$1.19
|
| Rate for Payer: HealthUtah PPO |
$1.95
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1.89
|
| Rate for Payer: Multiplan Medicare/VA |
$1.13
|
| Rate for Payer: One Health Plan of WY PPO |
$1.91
|
| Rate for Payer: PacificSource Commercial |
$1.76
|
| Rate for Payer: PHCS PPO |
$1.91
|
| Rate for Payer: Three Rivers PPO |
$1.46
|
| Rate for Payer: TriWest Veterans Administration |
$1.19
|
| Rate for Payer: United Healthcare Commercial |
$1.86
|
| Rate for Payer: United Healthcare Medicare |
$1.19
|
| Rate for Payer: WINHealth Partners Commercial |
$1.85
|
| Rate for Payer: Wise Provider Network Commercial |
$1.85
|
|
|
CAST PAD 4" SPECIALIST
|
Facility
|
OP
|
$2.22
|
|
| Hospital Charge Code |
2250077
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.20 |
| Max. Negotiated Rate |
$2.22 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2.18
|
| Rate for Payer: Aetna of WY Medicare |
$1.47
|
| Rate for Payer: Altius Commercial |
$2.13
|
| Rate for Payer: Beech Street Commercial |
$2.18
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$2.15
|
| Rate for Payer: Cash Price |
$1.56
|
| Rate for Payer: ChoiceCare Network Commercial |
$2.15
|
| Rate for Payer: Cigna of WY Commercial |
$2.18
|
| Rate for Payer: Entrust Commercial |
$2.11
|
| Rate for Payer: First Choice Health Commercial |
$2.11
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2.11
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$1.27
|
| Rate for Payer: HealthUtah PPO |
$2.22
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2.15
|
| Rate for Payer: Multiplan Medicare/VA |
$1.20
|
| Rate for Payer: One Health Plan of WY PPO |
$2.18
|
| Rate for Payer: PacificSource Commercial |
$2.00
|
| Rate for Payer: PHCS PPO |
$2.18
|
| Rate for Payer: Three Rivers PPO |
$1.66
|
| Rate for Payer: TriWest Veterans Administration |
$1.27
|
| Rate for Payer: United Healthcare Commercial |
$2.12
|
| Rate for Payer: United Healthcare Medicare |
$1.27
|
| Rate for Payer: WINHealth Partners Commercial |
$2.18
|
| Rate for Payer: Wise Provider Network Commercial |
$2.11
|
|
|
CAST PAD 4" SPECIALIST
|
Facility
|
IP
|
$2.22
|
|
| Hospital Charge Code |
2250077
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.29 |
| Max. Negotiated Rate |
$2.22 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2.18
|
| Rate for Payer: Aetna of WY Medicare |
$1.42
|
| Rate for Payer: Altius Commercial |
$2.13
|
| Rate for Payer: Beech Street Commercial |
$2.18
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$2.15
|
| Rate for Payer: Cash Price |
$1.56
|
| Rate for Payer: ChoiceCare Network Commercial |
$2.15
|
| Rate for Payer: Cigna of WY Commercial |
$2.18
|
| Rate for Payer: Entrust Commercial |
$2.11
|
| Rate for Payer: First Choice Health Commercial |
$2.11
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2.11
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$1.35
|
| Rate for Payer: HealthUtah PPO |
$2.22
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2.15
|
| Rate for Payer: Multiplan Medicare/VA |
$1.29
|
| Rate for Payer: One Health Plan of WY PPO |
$2.18
|
| Rate for Payer: PacificSource Commercial |
$2.00
|
| Rate for Payer: PHCS PPO |
$2.18
|
| Rate for Payer: Three Rivers PPO |
$1.66
|
| Rate for Payer: TriWest Veterans Administration |
$1.35
|
| Rate for Payer: United Healthcare Commercial |
$2.12
|
| Rate for Payer: United Healthcare Medicare |
$1.35
|
| Rate for Payer: WINHealth Partners Commercial |
$2.11
|
| Rate for Payer: Wise Provider Network Commercial |
$2.11
|
|
|
CAST PAD 4" STERILE SPECIALIST
|
Facility
|
OP
|
$4.54
|
|
| Hospital Charge Code |
2250121
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.46 |
| Max. Negotiated Rate |
$4.54 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$4.45
|
| Rate for Payer: Aetna of WY Medicare |
$3.00
|
| Rate for Payer: Altius Commercial |
$4.36
|
| Rate for Payer: Beech Street Commercial |
$4.45
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$4.40
|
| Rate for Payer: Cash Price |
$3.18
|
| Rate for Payer: ChoiceCare Network Commercial |
$4.40
|
| Rate for Payer: Cigna of WY Commercial |
$4.45
|
| Rate for Payer: Entrust Commercial |
$4.31
|
| Rate for Payer: First Choice Health Commercial |
$4.31
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$4.31
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$2.59
|
| Rate for Payer: HealthUtah PPO |
$4.54
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$4.40
|
| Rate for Payer: Multiplan Medicare/VA |
$2.46
|
| Rate for Payer: One Health Plan of WY PPO |
$4.45
|
| Rate for Payer: PacificSource Commercial |
$4.09
|
| Rate for Payer: PHCS PPO |
$4.45
|
| Rate for Payer: Three Rivers PPO |
$3.40
|
| Rate for Payer: TriWest Veterans Administration |
$2.59
|
| Rate for Payer: United Healthcare Commercial |
$4.34
|
| Rate for Payer: United Healthcare Medicare |
$2.59
|
| Rate for Payer: WINHealth Partners Commercial |
$4.45
|
| Rate for Payer: Wise Provider Network Commercial |
$4.31
|
|
|
CAST PAD 4" STERILE SPECIALIST
|
Facility
|
IP
|
$4.54
|
|
| Hospital Charge Code |
2250121
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.63 |
| Max. Negotiated Rate |
$4.54 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$4.45
|
| Rate for Payer: Aetna of WY Medicare |
$2.91
|
| Rate for Payer: Altius Commercial |
$4.36
|
| Rate for Payer: Beech Street Commercial |
$4.45
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$4.40
|
| Rate for Payer: Cash Price |
$3.18
|
| Rate for Payer: ChoiceCare Network Commercial |
$4.40
|
| Rate for Payer: Cigna of WY Commercial |
$4.45
|
| Rate for Payer: Entrust Commercial |
$4.31
|
| Rate for Payer: First Choice Health Commercial |
$4.31
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$4.31
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$2.77
|
| Rate for Payer: HealthUtah PPO |
$4.54
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$4.40
|
| Rate for Payer: Multiplan Medicare/VA |
$2.63
|
| Rate for Payer: One Health Plan of WY PPO |
$4.45
|
| Rate for Payer: PacificSource Commercial |
$4.09
|
| Rate for Payer: PHCS PPO |
$4.45
|
| Rate for Payer: Three Rivers PPO |
$3.40
|
| Rate for Payer: TriWest Veterans Administration |
$2.77
|
| Rate for Payer: United Healthcare Commercial |
$4.34
|
| Rate for Payer: United Healthcare Medicare |
$2.77
|
| Rate for Payer: WINHealth Partners Commercial |
$4.31
|
| Rate for Payer: Wise Provider Network Commercial |
$4.31
|
|
|
CAST PAD 4" SYNTHETIC
|
Facility
|
OP
|
$2.32
|
|
| Hospital Charge Code |
2250117
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.26 |
| Max. Negotiated Rate |
$2.32 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2.27
|
| Rate for Payer: Aetna of WY Medicare |
$1.53
|
| Rate for Payer: Altius Commercial |
$2.23
|
| Rate for Payer: Beech Street Commercial |
$2.27
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$2.25
|
| Rate for Payer: Cash Price |
$1.63
|
| Rate for Payer: ChoiceCare Network Commercial |
$2.25
|
| Rate for Payer: Cigna of WY Commercial |
$2.27
|
| Rate for Payer: Entrust Commercial |
$2.20
|
| Rate for Payer: First Choice Health Commercial |
$2.20
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2.20
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$1.32
|
| Rate for Payer: HealthUtah PPO |
$2.32
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2.25
|
| Rate for Payer: Multiplan Medicare/VA |
$1.26
|
| Rate for Payer: One Health Plan of WY PPO |
$2.27
|
| Rate for Payer: PacificSource Commercial |
$2.09
|
| Rate for Payer: PHCS PPO |
$2.27
|
| Rate for Payer: Three Rivers PPO |
$1.74
|
| Rate for Payer: TriWest Veterans Administration |
$1.32
|
| Rate for Payer: United Healthcare Commercial |
$2.22
|
| Rate for Payer: United Healthcare Medicare |
$1.32
|
| Rate for Payer: WINHealth Partners Commercial |
$2.27
|
| Rate for Payer: Wise Provider Network Commercial |
$2.20
|
|
