|
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
|
|
|
CAST PAD 6" SPECIALIST
|
Facility
|
IP
|
$3.80
|
|
| Hospital Charge Code |
2250076
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.20 |
| Max. Negotiated Rate |
$3.80 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3.72
|
| Rate for Payer: Aetna of WY Medicare |
$2.43
|
| Rate for Payer: Altius Commercial |
$3.65
|
| Rate for Payer: Beech Street Commercial |
$3.72
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$3.69
|
| Rate for Payer: Cash Price |
$2.66
|
| Rate for Payer: ChoiceCare Network Commercial |
$3.69
|
| Rate for Payer: Cigna of WY Commercial |
$3.72
|
| Rate for Payer: Entrust Commercial |
$3.61
|
| Rate for Payer: First Choice Health Commercial |
$3.61
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3.61
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$2.32
|
| Rate for Payer: HealthUtah PPO |
$3.80
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3.69
|
| Rate for Payer: Multiplan Medicare/VA |
$2.20
|
| Rate for Payer: One Health Plan of WY PPO |
$3.72
|
| Rate for Payer: PacificSource Commercial |
$3.42
|
| Rate for Payer: PHCS PPO |
$3.72
|
| Rate for Payer: Three Rivers PPO |
$2.85
|
| Rate for Payer: TriWest Veterans Administration |
$2.32
|
| Rate for Payer: United Healthcare Commercial |
$3.63
|
| Rate for Payer: United Healthcare Medicare |
$2.32
|
| Rate for Payer: WINHealth Partners Commercial |
$3.61
|
| Rate for Payer: Wise Provider Network Commercial |
$3.61
|
|
|
CAST PAD 6" SPECIALIST
|
Facility
|
OP
|
$3.80
|
|
| Hospital Charge Code |
2250076
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.06 |
| Max. Negotiated Rate |
$3.80 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3.72
|
| Rate for Payer: Aetna of WY Medicare |
$2.51
|
| Rate for Payer: Altius Commercial |
$3.65
|
| Rate for Payer: Beech Street Commercial |
$3.72
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$3.69
|
| Rate for Payer: Cash Price |
$2.66
|
| Rate for Payer: ChoiceCare Network Commercial |
$3.69
|
| Rate for Payer: Cigna of WY Commercial |
$3.72
|
| Rate for Payer: Entrust Commercial |
$3.61
|
| Rate for Payer: First Choice Health Commercial |
$3.61
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3.61
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$2.17
|
| Rate for Payer: HealthUtah PPO |
$3.80
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3.69
|
| Rate for Payer: Multiplan Medicare/VA |
$2.06
|
| Rate for Payer: One Health Plan of WY PPO |
$3.72
|
| Rate for Payer: PacificSource Commercial |
$3.42
|
| Rate for Payer: PHCS PPO |
$3.72
|
| Rate for Payer: Three Rivers PPO |
$2.85
|
| Rate for Payer: TriWest Veterans Administration |
$2.17
|
| Rate for Payer: United Healthcare Commercial |
$3.63
|
| Rate for Payer: United Healthcare Medicare |
$2.17
|
| Rate for Payer: WINHealth Partners Commercial |
$3.72
|
| Rate for Payer: Wise Provider Network Commercial |
$3.61
|
|
|
CAST PAD 6" STERILE SPECIALIST
|
Facility
|
OP
|
$9.83
|
|
| Hospital Charge Code |
2250122
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.32 |
| Max. Negotiated Rate |
$9.83 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$9.63
|
| Rate for Payer: Aetna of WY Medicare |
$6.49
|
| Rate for Payer: Altius Commercial |
$9.44
|
| Rate for Payer: Beech Street Commercial |
$9.63
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$9.54
|
| Rate for Payer: Cash Price |
$6.88
|
| Rate for Payer: ChoiceCare Network Commercial |
$9.54
|
| Rate for Payer: Cigna of WY Commercial |
$9.63
|
| Rate for Payer: Entrust Commercial |
$9.34
|
| Rate for Payer: First Choice Health Commercial |
$9.34
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$9.34
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$5.60
|
| Rate for Payer: HealthUtah PPO |
$9.83
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$9.54
|
| Rate for Payer: Multiplan Medicare/VA |
$5.32
|
| Rate for Payer: One Health Plan of WY PPO |
$9.63
|
| Rate for Payer: PacificSource Commercial |
$8.85
|
| Rate for Payer: PHCS PPO |
$9.63
|
| Rate for Payer: Three Rivers PPO |
$7.37
|
| Rate for Payer: TriWest Veterans Administration |
$5.60
|
| Rate for Payer: United Healthcare Commercial |
$9.39
|
| Rate for Payer: United Healthcare Medicare |
$5.60
|
| Rate for Payer: WINHealth Partners Commercial |
$9.63
|
| Rate for Payer: Wise Provider Network Commercial |
$9.34
|
|
|
CAST PAD 6" STERILE SPECIALIST
|
Facility
|
IP
|
$9.83
|
|
| Hospital Charge Code |
2250122
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.70 |
| Max. Negotiated Rate |
$9.83 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$9.63
|
| Rate for Payer: Aetna of WY Medicare |
$6.29
|
| Rate for Payer: Altius Commercial |
$9.44
|
| Rate for Payer: Beech Street Commercial |
$9.63
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$9.54
|
| Rate for Payer: Cash Price |
$6.88
|
| Rate for Payer: ChoiceCare Network Commercial |
$9.54
|
| Rate for Payer: Cigna of WY Commercial |
$9.63
|
| Rate for Payer: Entrust Commercial |
$9.34
|
| Rate for Payer: First Choice Health Commercial |
$9.34
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$9.34
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$6.00
|
| Rate for Payer: HealthUtah PPO |
$9.83
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$9.54
|
| Rate for Payer: Multiplan Medicare/VA |
$5.70
|
| Rate for Payer: One Health Plan of WY PPO |
$9.63
|
| Rate for Payer: PacificSource Commercial |
$8.85
|
| Rate for Payer: PHCS PPO |
$9.63
|
| Rate for Payer: Three Rivers PPO |
$7.37
|
| Rate for Payer: TriWest Veterans Administration |
$6.00
|
| Rate for Payer: United Healthcare Commercial |
$9.39
|
| Rate for Payer: United Healthcare Medicare |
$6.00
|
| Rate for Payer: WINHealth Partners Commercial |
$9.34
|
| Rate for Payer: Wise Provider Network Commercial |
$9.34
|
|
|
CAST PAD 6" SYNTHETIC
|
Facility
|
OP
|
$3.61
|
|
| Hospital Charge Code |
2250118
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.95 |
| Max. Negotiated Rate |
$3.61 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3.54
|
| Rate for Payer: Aetna of WY Medicare |
$2.38
|
| Rate for Payer: Altius Commercial |
$3.47
|
| Rate for Payer: Beech Street Commercial |
$3.54
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$3.50
|
| Rate for Payer: Cash Price |
$2.53
|
| Rate for Payer: ChoiceCare Network Commercial |
$3.50
|
| Rate for Payer: Cigna of WY Commercial |
$3.54
|
| Rate for Payer: Entrust Commercial |
$3.43
|
| Rate for Payer: First Choice Health Commercial |
$3.43
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3.43
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$2.06
|
| Rate for Payer: HealthUtah PPO |
$3.61
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3.50
|
| Rate for Payer: Multiplan Medicare/VA |
$1.95
|
| Rate for Payer: One Health Plan of WY PPO |
$3.54
|
| Rate for Payer: PacificSource Commercial |
$3.25
|
| Rate for Payer: PHCS PPO |
$3.54
|
| Rate for Payer: Three Rivers PPO |
$2.71
|
| Rate for Payer: TriWest Veterans Administration |
$2.06
|
| Rate for Payer: United Healthcare Commercial |
$3.45
|
| Rate for Payer: United Healthcare Medicare |
$2.06
|
| Rate for Payer: WINHealth Partners Commercial |
$3.54
|
| Rate for Payer: Wise Provider Network Commercial |
$3.43
|
|
|
CAST PAD 6" SYNTHETIC
|
Facility
|
IP
|
$3.61
|
|
| Hospital Charge Code |
2250118
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.09 |
| Max. Negotiated Rate |
$3.61 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3.54
|
| Rate for Payer: Aetna of WY Medicare |
$2.31
|
| Rate for Payer: Altius Commercial |
$3.47
|
| Rate for Payer: Beech Street Commercial |
$3.54
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$3.50
|
| Rate for Payer: Cash Price |
$2.53
|
| Rate for Payer: ChoiceCare Network Commercial |
$3.50
|
| Rate for Payer: Cigna of WY Commercial |
$3.54
|
| Rate for Payer: Entrust Commercial |
$3.43
|
| Rate for Payer: First Choice Health Commercial |
$3.43
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3.43
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$2.20
|
| Rate for Payer: HealthUtah PPO |
$3.61
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3.50
|
| Rate for Payer: Multiplan Medicare/VA |
$2.09
|
| Rate for Payer: One Health Plan of WY PPO |
$3.54
|
| Rate for Payer: PacificSource Commercial |
$3.25
|
| Rate for Payer: PHCS PPO |
$3.54
|
| Rate for Payer: Three Rivers PPO |
$2.71
|
| Rate for Payer: TriWest Veterans Administration |
$2.20
|
| Rate for Payer: United Healthcare Commercial |
$3.45
|
| Rate for Payer: United Healthcare Medicare |
$2.20
|
| Rate for Payer: WINHealth Partners Commercial |
$3.43
|
| Rate for Payer: Wise Provider Network Commercial |
$3.43
|
|
|
CAST REMOVAL AID ZIP STICK
|
Facility
|
OP
|
$8.26
|
|
| Hospital Charge Code |
2250140
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.47 |
| Max. Negotiated Rate |
$8.26 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$8.09
|
| Rate for Payer: Aetna of WY Medicare |
$5.45
|
| Rate for Payer: Altius Commercial |
$7.93
|
| Rate for Payer: Beech Street Commercial |
$8.09
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$8.01
|
| Rate for Payer: Cash Price |
$5.78
|
| Rate for Payer: ChoiceCare Network Commercial |
$8.01
|
| Rate for Payer: Cigna of WY Commercial |
$8.09
|
| Rate for Payer: Entrust Commercial |
$7.85
|
| Rate for Payer: First Choice Health Commercial |
$7.85
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$7.85
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$4.71
|
| Rate for Payer: HealthUtah PPO |
$8.26
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$8.01
|
| Rate for Payer: Multiplan Medicare/VA |
$4.47
|
| Rate for Payer: One Health Plan of WY PPO |
$8.09
|
| Rate for Payer: PacificSource Commercial |
$7.43
|
| Rate for Payer: PHCS PPO |
$8.09
|
| Rate for Payer: Three Rivers PPO |
$6.20
|
| Rate for Payer: TriWest Veterans Administration |
$4.71
|
| Rate for Payer: United Healthcare Commercial |
$7.89
|
| Rate for Payer: United Healthcare Medicare |
$4.71
|
| Rate for Payer: WINHealth Partners Commercial |
$8.09
|
| Rate for Payer: Wise Provider Network Commercial |
$7.85
|
|
|
CAST REMOVAL AID ZIP STICK
|
Facility
|
IP
|
$8.26
|
|
| Hospital Charge Code |
2250140
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.79 |
| Max. Negotiated Rate |
$8.26 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$8.09
|
| Rate for Payer: Aetna of WY Medicare |
$5.29
|
| Rate for Payer: Altius Commercial |
$7.93
|
| Rate for Payer: Beech Street Commercial |
$8.09
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$8.01
|
| Rate for Payer: Cash Price |
$5.78
|
| Rate for Payer: ChoiceCare Network Commercial |
$8.01
|
| Rate for Payer: Cigna of WY Commercial |
$8.09
|
| Rate for Payer: Entrust Commercial |
$7.85
|
| Rate for Payer: First Choice Health Commercial |
$7.85
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$7.85
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$5.04
|
| Rate for Payer: HealthUtah PPO |
$8.26
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$8.01
|
| Rate for Payer: Multiplan Medicare/VA |
$4.79
|
| Rate for Payer: One Health Plan of WY PPO |
$8.09
|
| Rate for Payer: PacificSource Commercial |
$7.43
|
| Rate for Payer: PHCS PPO |
$8.09
|
| Rate for Payer: Three Rivers PPO |
$6.20
|
| Rate for Payer: TriWest Veterans Administration |
$5.04
|
| Rate for Payer: United Healthcare Commercial |
$7.89
|
| Rate for Payer: United Healthcare Medicare |
$5.04
|
| Rate for Payer: WINHealth Partners Commercial |
$7.85
|
| Rate for Payer: Wise Provider Network Commercial |
$7.85
|
|
|
CAST SUP SHT ARM ADULT FBRGL
|
Professional
|
Both
|
$136.00
|
|
|
Service Code
|
HCPCS Q4010
|
| Min. Negotiated Rate |
$102.00 |
| Max. Negotiated Rate |
$136.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$133.28
|
| Rate for Payer: Beech Street Commercial |
$129.20
|
| Rate for Payer: Cash Price |
$95.20
|
| Rate for Payer: ChoiceCare Network Commercial |
$131.92
|
| Rate for Payer: Cigna of WY Commercial |
$133.28
|
| Rate for Payer: First Choice Health Commercial |
$122.40
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$129.20
|
| Rate for Payer: HealthUtah PPO |
$136.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$131.92
|
| Rate for Payer: One Health Plan of WY PPO |
$133.28
|
| Rate for Payer: PacificSource Commercial |
$122.40
|
| Rate for Payer: PHCS PPO |
$129.20
|
| Rate for Payer: Three Rivers PPO |
$102.00
|
| Rate for Payer: United Healthcare Commercial |
$129.20
|
| Rate for Payer: WINHealth Partners Commercial |
$129.20
|
|
|
CAST TAPE 2" BLACK CONFORMABLE
|
Facility
|
IP
|
$8.83
|
|
| Hospital Charge Code |
2250149
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$5.12 |
| Max. Negotiated Rate |
$8.83 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$8.65
|
| Rate for Payer: Aetna of WY Medicare |
$5.65
|
| Rate for Payer: Altius Commercial |
$8.48
|
| Rate for Payer: Beech Street Commercial |
$8.65
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$8.57
|
| Rate for Payer: Cash Price |
$6.18
|
| Rate for Payer: ChoiceCare Network Commercial |
$8.57
|
| Rate for Payer: Cigna of WY Commercial |
$8.65
|
| Rate for Payer: Entrust Commercial |
$8.39
|
| Rate for Payer: First Choice Health Commercial |
$8.39
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$8.39
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$5.39
|
| Rate for Payer: HealthUtah PPO |
$8.83
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$8.57
|
| Rate for Payer: Multiplan Medicare/VA |
$5.12
|
| Rate for Payer: One Health Plan of WY PPO |
$8.65
|
| Rate for Payer: PacificSource Commercial |
$7.95
|
| Rate for Payer: PHCS PPO |
$8.65
|
| Rate for Payer: Three Rivers PPO |
$6.62
|
| Rate for Payer: TriWest Veterans Administration |
$5.39
|
| Rate for Payer: United Healthcare Commercial |
$8.43
|
| Rate for Payer: United Healthcare Medicare |
$5.39
|
| Rate for Payer: WINHealth Partners Commercial |
$8.39
|
| Rate for Payer: Wise Provider Network Commercial |
$8.39
|
|
|
CAST TAPE 2" BLACK CONFORMABLE
|
Facility
|
OP
|
$8.83
|
|
| Hospital Charge Code |
2250149
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$4.78 |
| Max. Negotiated Rate |
$8.83 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$8.65
|
| Rate for Payer: Aetna of WY Medicare |
$5.83
|
| Rate for Payer: Altius Commercial |
$8.48
|
| Rate for Payer: Beech Street Commercial |
$8.65
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$8.57
|
| Rate for Payer: Cash Price |
$6.18
|
| Rate for Payer: ChoiceCare Network Commercial |
$8.57
|
| Rate for Payer: Cigna of WY Commercial |
$8.65
|
| Rate for Payer: Entrust Commercial |
$8.39
|
| Rate for Payer: First Choice Health Commercial |
$8.39
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$8.39
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$5.03
|
| Rate for Payer: HealthUtah PPO |
$8.83
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$8.57
|
| Rate for Payer: Multiplan Medicare/VA |
$4.78
|
| Rate for Payer: One Health Plan of WY PPO |
$8.65
|
| Rate for Payer: PacificSource Commercial |
$7.95
|
| Rate for Payer: PHCS PPO |
$8.65
|
| Rate for Payer: Three Rivers PPO |
$6.62
|
| Rate for Payer: TriWest Veterans Administration |
$5.03
|
| Rate for Payer: United Healthcare Commercial |
$8.43
|
| Rate for Payer: United Healthcare Medicare |
$5.03
|
| Rate for Payer: WINHealth Partners Commercial |
$8.65
|
| Rate for Payer: Wise Provider Network Commercial |
$8.39
|
|
|
CAST TAPE 2" BLACK DELTA LITE
|
Facility
|
IP
|
$5.97
|
|
| Hospital Charge Code |
2250009
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.46 |
| Max. Negotiated Rate |
$5.97 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$5.85
|
| Rate for Payer: Aetna of WY Medicare |
$3.82
|
| Rate for Payer: Altius Commercial |
$5.73
|
| Rate for Payer: Beech Street Commercial |
$5.85
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$5.79
|
| Rate for Payer: Cash Price |
$4.18
|
| Rate for Payer: ChoiceCare Network Commercial |
$5.79
|
| Rate for Payer: Cigna of WY Commercial |
$5.85
|
| Rate for Payer: Entrust Commercial |
$5.67
|
| Rate for Payer: First Choice Health Commercial |
$5.67
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$5.67
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$3.64
|
| Rate for Payer: HealthUtah PPO |
$5.97
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$5.79
|
| Rate for Payer: Multiplan Medicare/VA |
$3.46
|
| Rate for Payer: One Health Plan of WY PPO |
$5.85
|
| Rate for Payer: PacificSource Commercial |
$5.37
|
| Rate for Payer: PHCS PPO |
$5.85
|
| Rate for Payer: Three Rivers PPO |
$4.48
|
| Rate for Payer: TriWest Veterans Administration |
$3.64
|
| Rate for Payer: United Healthcare Commercial |
$5.70
|
| Rate for Payer: United Healthcare Medicare |
$3.64
|
| Rate for Payer: WINHealth Partners Commercial |
$5.67
|
| Rate for Payer: Wise Provider Network Commercial |
$5.67
|
|
|
CAST TAPE 2" BLACK DELTA LITE
|
Facility
|
OP
|
$5.97
|
|
| Hospital Charge Code |
2250009
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.23 |
| Max. Negotiated Rate |
$5.97 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$5.85
|
| Rate for Payer: Aetna of WY Medicare |
$3.94
|
| Rate for Payer: Altius Commercial |
$5.73
|
| Rate for Payer: Beech Street Commercial |
$5.85
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$5.79
|
| Rate for Payer: Cash Price |
$4.18
|
| Rate for Payer: ChoiceCare Network Commercial |
$5.79
|
| Rate for Payer: Cigna of WY Commercial |
$5.85
|
| Rate for Payer: Entrust Commercial |
$5.67
|
| Rate for Payer: First Choice Health Commercial |
$5.67
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$5.67
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$3.40
|
| Rate for Payer: HealthUtah PPO |
$5.97
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$5.79
|
| Rate for Payer: Multiplan Medicare/VA |
$3.23
|
| Rate for Payer: One Health Plan of WY PPO |
$5.85
|
| Rate for Payer: PacificSource Commercial |
$5.37
|
| Rate for Payer: PHCS PPO |
$5.85
|
| Rate for Payer: Three Rivers PPO |
$4.48
|
| Rate for Payer: TriWest Veterans Administration |
$3.40
|
| Rate for Payer: United Healthcare Commercial |
$5.70
|
| Rate for Payer: United Healthcare Medicare |
$3.40
|
| Rate for Payer: WINHealth Partners Commercial |
$5.85
|
| Rate for Payer: Wise Provider Network Commercial |
$5.67
|
|
|
CAST TAPE 2" BLUE CONFORMABLE
|
Facility
|
OP
|
$8.81
|
|
| Hospital Charge Code |
2250150
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.77 |
| Max. Negotiated Rate |
$8.81 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$8.63
|
| Rate for Payer: Aetna of WY Medicare |
$5.81
|
| Rate for Payer: Altius Commercial |
$8.46
|
| Rate for Payer: Beech Street Commercial |
$8.63
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$8.55
|
| Rate for Payer: Cash Price |
$6.17
|
| Rate for Payer: ChoiceCare Network Commercial |
$8.55
|
| Rate for Payer: Cigna of WY Commercial |
$8.63
|
| Rate for Payer: Entrust Commercial |
$8.37
|
| Rate for Payer: First Choice Health Commercial |
$8.37
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$8.37
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$5.02
|
| Rate for Payer: HealthUtah PPO |
$8.81
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$8.55
|
| Rate for Payer: Multiplan Medicare/VA |
$4.77
|
| Rate for Payer: One Health Plan of WY PPO |
$8.63
|
| Rate for Payer: PacificSource Commercial |
$7.93
|
| Rate for Payer: PHCS PPO |
$8.63
|
| Rate for Payer: Three Rivers PPO |
$6.61
|
| Rate for Payer: TriWest Veterans Administration |
$5.02
|
| Rate for Payer: United Healthcare Commercial |
$8.41
|
| Rate for Payer: United Healthcare Medicare |
$5.02
|
| Rate for Payer: WINHealth Partners Commercial |
$8.63
|
| Rate for Payer: Wise Provider Network Commercial |
$8.37
|
|
|
CAST TAPE 2" BLUE CONFORMABLE
|
Facility
|
IP
|
$8.81
|
|
| Hospital Charge Code |
2250150
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.11 |
| Max. Negotiated Rate |
$8.81 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$8.63
|
| Rate for Payer: Aetna of WY Medicare |
$5.64
|
| Rate for Payer: Altius Commercial |
$8.46
|
| Rate for Payer: Beech Street Commercial |
$8.63
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$8.55
|
| Rate for Payer: Cash Price |
$6.17
|
| Rate for Payer: ChoiceCare Network Commercial |
$8.55
|
| Rate for Payer: Cigna of WY Commercial |
$8.63
|
| Rate for Payer: Entrust Commercial |
$8.37
|
| Rate for Payer: First Choice Health Commercial |
$8.37
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$8.37
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$5.37
|
| Rate for Payer: HealthUtah PPO |
$8.81
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$8.55
|
| Rate for Payer: Multiplan Medicare/VA |
$5.11
|
| Rate for Payer: One Health Plan of WY PPO |
$8.63
|
| Rate for Payer: PacificSource Commercial |
$7.93
|
| Rate for Payer: PHCS PPO |
$8.63
|
| Rate for Payer: Three Rivers PPO |
$6.61
|
| Rate for Payer: TriWest Veterans Administration |
$5.37
|
| Rate for Payer: United Healthcare Commercial |
$8.41
|
| Rate for Payer: United Healthcare Medicare |
$5.37
|
| Rate for Payer: WINHealth Partners Commercial |
$8.37
|
| Rate for Payer: Wise Provider Network Commercial |
$8.37
|
|
|
CAST TAPE 2" BLUE DELTA LITE
|
Facility
|
OP
|
$5.97
|
|
| Hospital Charge Code |
2250010
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3.23 |
| Max. Negotiated Rate |
$5.97 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$5.85
|
| Rate for Payer: Aetna of WY Medicare |
$3.94
|
| Rate for Payer: Altius Commercial |
$5.73
|
| Rate for Payer: Beech Street Commercial |
$5.85
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$5.79
|
| Rate for Payer: Cash Price |
$4.18
|
| Rate for Payer: ChoiceCare Network Commercial |
$5.79
|
| Rate for Payer: Cigna of WY Commercial |
$5.85
|
| Rate for Payer: Entrust Commercial |
$5.67
|
| Rate for Payer: First Choice Health Commercial |
$5.67
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$5.67
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$3.40
|
| Rate for Payer: HealthUtah PPO |
$5.97
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$5.79
|
| Rate for Payer: Multiplan Medicare/VA |
$3.23
|
| Rate for Payer: One Health Plan of WY PPO |
$5.85
|
| Rate for Payer: PacificSource Commercial |
$5.37
|
| Rate for Payer: PHCS PPO |
$5.85
|
| Rate for Payer: Three Rivers PPO |
$4.48
|
| Rate for Payer: TriWest Veterans Administration |
$3.40
|
| Rate for Payer: United Healthcare Commercial |
$5.70
|
| Rate for Payer: United Healthcare Medicare |
$3.40
|
| Rate for Payer: WINHealth Partners Commercial |
$5.85
|
| Rate for Payer: Wise Provider Network Commercial |
$5.67
|
|
|
CAST TAPE 2" BLUE DELTA LITE
|
Facility
|
IP
|
$5.97
|
|
| Hospital Charge Code |
2250010
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3.46 |
| Max. Negotiated Rate |
$5.97 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$5.85
|
| Rate for Payer: Aetna of WY Medicare |
$3.82
|
| Rate for Payer: Altius Commercial |
$5.73
|
| Rate for Payer: Beech Street Commercial |
$5.85
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$5.79
|
| Rate for Payer: Cash Price |
$4.18
|
| Rate for Payer: ChoiceCare Network Commercial |
$5.79
|
| Rate for Payer: Cigna of WY Commercial |
$5.85
|
| Rate for Payer: Entrust Commercial |
$5.67
|
| Rate for Payer: First Choice Health Commercial |
$5.67
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$5.67
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$3.64
|
| Rate for Payer: HealthUtah PPO |
$5.97
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$5.79
|
| Rate for Payer: Multiplan Medicare/VA |
$3.46
|
| Rate for Payer: One Health Plan of WY PPO |
$5.85
|
| Rate for Payer: PacificSource Commercial |
$5.37
|
| Rate for Payer: PHCS PPO |
$5.85
|
| Rate for Payer: Three Rivers PPO |
$4.48
|
| Rate for Payer: TriWest Veterans Administration |
$3.64
|
| Rate for Payer: United Healthcare Commercial |
$5.70
|
| Rate for Payer: United Healthcare Medicare |
$3.64
|
| Rate for Payer: WINHealth Partners Commercial |
$5.67
|
| Rate for Payer: Wise Provider Network Commercial |
$5.67
|
|
|
CAST TAPE 2" GREEN CONFORMABLE
|
Facility
|
IP
|
$8.81
|
|
| Hospital Charge Code |
2250160
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.11 |
| Max. Negotiated Rate |
$8.81 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$8.63
|
| Rate for Payer: Aetna of WY Medicare |
$5.64
|
| Rate for Payer: Altius Commercial |
$8.46
|
| Rate for Payer: Beech Street Commercial |
$8.63
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$8.55
|
| Rate for Payer: Cash Price |
$6.17
|
| Rate for Payer: ChoiceCare Network Commercial |
$8.55
|
| Rate for Payer: Cigna of WY Commercial |
$8.63
|
| Rate for Payer: Entrust Commercial |
$8.37
|
| Rate for Payer: First Choice Health Commercial |
$8.37
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$8.37
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$5.37
|
| Rate for Payer: HealthUtah PPO |
$8.81
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$8.55
|
| Rate for Payer: Multiplan Medicare/VA |
$5.11
|
| Rate for Payer: One Health Plan of WY PPO |
$8.63
|
| Rate for Payer: PacificSource Commercial |
$7.93
|
| Rate for Payer: PHCS PPO |
$8.63
|
| Rate for Payer: Three Rivers PPO |
$6.61
|
| Rate for Payer: TriWest Veterans Administration |
$5.37
|
| Rate for Payer: United Healthcare Commercial |
$8.41
|
| Rate for Payer: United Healthcare Medicare |
$5.37
|
| Rate for Payer: WINHealth Partners Commercial |
$8.37
|
| Rate for Payer: Wise Provider Network Commercial |
$8.37
|
|
|
CAST TAPE 2" GREEN CONFORMABLE
|
Facility
|
OP
|
$8.81
|
|
| Hospital Charge Code |
2250160
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.77 |
| Max. Negotiated Rate |
$8.81 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$8.63
|
| Rate for Payer: Aetna of WY Medicare |
$5.81
|
| Rate for Payer: Altius Commercial |
$8.46
|
| Rate for Payer: Beech Street Commercial |
$8.63
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$8.55
|
| Rate for Payer: Cash Price |
$6.17
|
| Rate for Payer: ChoiceCare Network Commercial |
$8.55
|
| Rate for Payer: Cigna of WY Commercial |
$8.63
|
| Rate for Payer: Entrust Commercial |
$8.37
|
| Rate for Payer: First Choice Health Commercial |
$8.37
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$8.37
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$5.02
|
| Rate for Payer: HealthUtah PPO |
$8.81
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$8.55
|
| Rate for Payer: Multiplan Medicare/VA |
$4.77
|
| Rate for Payer: One Health Plan of WY PPO |
$8.63
|
| Rate for Payer: PacificSource Commercial |
$7.93
|
| Rate for Payer: PHCS PPO |
$8.63
|
| Rate for Payer: Three Rivers PPO |
$6.61
|
| Rate for Payer: TriWest Veterans Administration |
$5.02
|
| Rate for Payer: United Healthcare Commercial |
$8.41
|
| Rate for Payer: United Healthcare Medicare |
$5.02
|
| Rate for Payer: WINHealth Partners Commercial |
$8.63
|
| Rate for Payer: Wise Provider Network Commercial |
$8.37
|
|
|
CAST TAPE 2" PINK CONFORMABLE
|
Facility
|
IP
|
$8.83
|
|
| Hospital Charge Code |
2250148
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.12 |
| Max. Negotiated Rate |
$8.83 |
| Rate for Payer: United Healthcare Commercial |
$8.43
|
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$8.65
|
| Rate for Payer: Aetna of WY Medicare |
$5.65
|
| Rate for Payer: Altius Commercial |
$8.48
|
| Rate for Payer: Beech Street Commercial |
$8.65
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$8.57
|
| Rate for Payer: Cash Price |
$6.18
|
| Rate for Payer: ChoiceCare Network Commercial |
$8.57
|
| Rate for Payer: Cigna of WY Commercial |
$8.65
|
| Rate for Payer: Entrust Commercial |
$8.39
|
| Rate for Payer: First Choice Health Commercial |
$8.39
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$8.39
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$5.39
|
| Rate for Payer: HealthUtah PPO |
$8.83
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$8.57
|
| Rate for Payer: Multiplan Medicare/VA |
$5.12
|
| Rate for Payer: One Health Plan of WY PPO |
$8.65
|
| Rate for Payer: PacificSource Commercial |
$7.95
|
| Rate for Payer: PHCS PPO |
$8.65
|
| Rate for Payer: Three Rivers PPO |
$6.62
|
| Rate for Payer: TriWest Veterans Administration |
$5.39
|
| Rate for Payer: United Healthcare Medicare |
$5.39
|
| Rate for Payer: WINHealth Partners Commercial |
$8.39
|
| Rate for Payer: Wise Provider Network Commercial |
$8.39
|
|
|
CAST TAPE 2" PINK CONFORMABLE
|
Facility
|
OP
|
$8.83
|
|
| Hospital Charge Code |
2250148
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.78 |
| Max. Negotiated Rate |
$8.83 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$8.65
|
| Rate for Payer: Aetna of WY Medicare |
$5.83
|
| Rate for Payer: Altius Commercial |
$8.48
|
| Rate for Payer: Beech Street Commercial |
$8.65
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$8.57
|
| Rate for Payer: Cash Price |
$6.18
|
| Rate for Payer: ChoiceCare Network Commercial |
$8.57
|
| Rate for Payer: Cigna of WY Commercial |
$8.65
|
| Rate for Payer: Entrust Commercial |
$8.39
|
| Rate for Payer: First Choice Health Commercial |
$8.39
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$8.39
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$5.03
|
| Rate for Payer: HealthUtah PPO |
$8.83
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$8.57
|
| Rate for Payer: Multiplan Medicare/VA |
$4.78
|
| Rate for Payer: One Health Plan of WY PPO |
$8.65
|
| Rate for Payer: PacificSource Commercial |
$7.95
|
| Rate for Payer: PHCS PPO |
$8.65
|
| Rate for Payer: Three Rivers PPO |
$6.62
|
| Rate for Payer: TriWest Veterans Administration |
$5.03
|
| Rate for Payer: United Healthcare Commercial |
$8.43
|
| Rate for Payer: United Healthcare Medicare |
$5.03
|
| Rate for Payer: WINHealth Partners Commercial |
$8.65
|
| Rate for Payer: Wise Provider Network Commercial |
$8.39
|
|
|
CAST TAPE 2" PINK DELTA LITE
|
Facility
|
IP
|
$5.97
|
|
| Hospital Charge Code |
2250013
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.46 |
| Max. Negotiated Rate |
$5.97 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$5.85
|
| Rate for Payer: Aetna of WY Medicare |
$3.82
|
| Rate for Payer: Altius Commercial |
$5.73
|
| Rate for Payer: Beech Street Commercial |
$5.85
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$5.79
|
| Rate for Payer: Cash Price |
$4.18
|
| Rate for Payer: ChoiceCare Network Commercial |
$5.79
|
| Rate for Payer: Cigna of WY Commercial |
$5.85
|
| Rate for Payer: Entrust Commercial |
$5.67
|
| Rate for Payer: First Choice Health Commercial |
$5.67
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$5.67
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$3.64
|
| Rate for Payer: HealthUtah PPO |
$5.97
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$5.79
|
| Rate for Payer: Multiplan Medicare/VA |
$3.46
|
| Rate for Payer: One Health Plan of WY PPO |
$5.85
|
| Rate for Payer: PacificSource Commercial |
$5.37
|
| Rate for Payer: PHCS PPO |
$5.85
|
| Rate for Payer: Three Rivers PPO |
$4.48
|
| Rate for Payer: TriWest Veterans Administration |
$3.64
|
| Rate for Payer: United Healthcare Commercial |
$5.70
|
| Rate for Payer: United Healthcare Medicare |
$3.64
|
| Rate for Payer: WINHealth Partners Commercial |
$5.67
|
| Rate for Payer: Wise Provider Network Commercial |
$5.67
|
|
|
CAST TAPE 2" PINK DELTA LITE
|
Facility
|
OP
|
$5.97
|
|
| Hospital Charge Code |
2250013
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.23 |
| Max. Negotiated Rate |
$5.97 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$5.85
|
| Rate for Payer: Aetna of WY Medicare |
$3.94
|
| Rate for Payer: Altius Commercial |
$5.73
|
| Rate for Payer: Beech Street Commercial |
$5.85
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$5.79
|
| Rate for Payer: Cash Price |
$4.18
|
| Rate for Payer: ChoiceCare Network Commercial |
$5.79
|
| Rate for Payer: Cigna of WY Commercial |
$5.85
|
| Rate for Payer: Entrust Commercial |
$5.67
|
| Rate for Payer: First Choice Health Commercial |
$5.67
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$5.67
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$3.40
|
| Rate for Payer: HealthUtah PPO |
$5.97
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$5.79
|
| Rate for Payer: Multiplan Medicare/VA |
$3.23
|
| Rate for Payer: One Health Plan of WY PPO |
$5.85
|
| Rate for Payer: PacificSource Commercial |
$5.37
|
| Rate for Payer: PHCS PPO |
$5.85
|
| Rate for Payer: Three Rivers PPO |
$4.48
|
| Rate for Payer: TriWest Veterans Administration |
$3.40
|
| Rate for Payer: United Healthcare Commercial |
$5.70
|
| Rate for Payer: United Healthcare Medicare |
$3.40
|
| Rate for Payer: WINHealth Partners Commercial |
$5.85
|
| Rate for Payer: Wise Provider Network Commercial |
$5.67
|
|
|
CAST TAPE 2" PURPLE CONFORMABL
|
Facility
|
IP
|
$8.81
|
|
| Hospital Charge Code |
2250146
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.11 |
| Max. Negotiated Rate |
$8.81 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$8.63
|
| Rate for Payer: Aetna of WY Medicare |
$5.64
|
| Rate for Payer: Altius Commercial |
$8.46
|
| Rate for Payer: Beech Street Commercial |
$8.63
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$8.55
|
| Rate for Payer: Cash Price |
$6.17
|
| Rate for Payer: ChoiceCare Network Commercial |
$8.55
|
| Rate for Payer: Cigna of WY Commercial |
$8.63
|
| Rate for Payer: Entrust Commercial |
$8.37
|
| Rate for Payer: First Choice Health Commercial |
$8.37
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$8.37
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$5.37
|
| Rate for Payer: HealthUtah PPO |
$8.81
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$8.55
|
| Rate for Payer: Multiplan Medicare/VA |
$5.11
|
| Rate for Payer: One Health Plan of WY PPO |
$8.63
|
| Rate for Payer: PacificSource Commercial |
$7.93
|
| Rate for Payer: PHCS PPO |
$8.63
|
| Rate for Payer: Three Rivers PPO |
$6.61
|
| Rate for Payer: TriWest Veterans Administration |
$5.37
|
| Rate for Payer: United Healthcare Commercial |
$8.41
|
| Rate for Payer: United Healthcare Medicare |
$5.37
|
| Rate for Payer: WINHealth Partners Commercial |
$8.37
|
| Rate for Payer: Wise Provider Network Commercial |
$8.37
|
|
