|
CAST TAPE 2" PURPLE CONFORMABL
|
Facility
|
OP
|
$8.81
|
|
| Hospital Charge Code |
2250146
|
|
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" PURPLE DELTA LITE
|
Facility
|
IP
|
$5.97
|
|
| Hospital Charge Code |
2250011
|
|
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" PURPLE DELTA LITE
|
Facility
|
OP
|
$5.97
|
|
| Hospital Charge Code |
2250011
|
|
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" RED CONFORMABLE
|
Facility
|
IP
|
$88.27
|
|
| Hospital Charge Code |
2250147
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$51.15 |
| Max. Negotiated Rate |
$88.27 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$86.50
|
| Rate for Payer: Aetna of WY Medicare |
$56.49
|
| Rate for Payer: Altius Commercial |
$84.74
|
| Rate for Payer: Beech Street Commercial |
$86.50
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$85.62
|
| Rate for Payer: Cash Price |
$61.79
|
| Rate for Payer: ChoiceCare Network Commercial |
$85.62
|
| Rate for Payer: Cigna of WY Commercial |
$86.50
|
| Rate for Payer: Entrust Commercial |
$83.86
|
| Rate for Payer: First Choice Health Commercial |
$83.86
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$83.86
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$53.84
|
| Rate for Payer: HealthUtah PPO |
$88.27
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$85.62
|
| Rate for Payer: Multiplan Medicare/VA |
$51.15
|
| Rate for Payer: One Health Plan of WY PPO |
$86.50
|
| Rate for Payer: PacificSource Commercial |
$79.44
|
| Rate for Payer: PHCS PPO |
$86.50
|
| Rate for Payer: Three Rivers PPO |
$66.20
|
| Rate for Payer: TriWest Veterans Administration |
$53.84
|
| Rate for Payer: United Healthcare Commercial |
$84.30
|
| Rate for Payer: United Healthcare Medicare |
$53.84
|
| Rate for Payer: WINHealth Partners Commercial |
$83.86
|
| Rate for Payer: Wise Provider Network Commercial |
$83.86
|
|
|
CAST TAPE 2" RED CONFORMABLE
|
Facility
|
OP
|
$88.27
|
|
| Hospital Charge Code |
2250147
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$47.80 |
| Max. Negotiated Rate |
$88.27 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$86.50
|
| Rate for Payer: Aetna of WY Medicare |
$58.26
|
| Rate for Payer: Altius Commercial |
$84.74
|
| Rate for Payer: Beech Street Commercial |
$86.50
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$85.62
|
| Rate for Payer: Cash Price |
$61.79
|
| Rate for Payer: ChoiceCare Network Commercial |
$85.62
|
| Rate for Payer: Cigna of WY Commercial |
$86.50
|
| Rate for Payer: Entrust Commercial |
$83.86
|
| Rate for Payer: First Choice Health Commercial |
$83.86
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$83.86
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$50.31
|
| Rate for Payer: HealthUtah PPO |
$88.27
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$85.62
|
| Rate for Payer: Multiplan Medicare/VA |
$47.80
|
| Rate for Payer: One Health Plan of WY PPO |
$86.50
|
| Rate for Payer: PacificSource Commercial |
$79.44
|
| Rate for Payer: PHCS PPO |
$86.50
|
| Rate for Payer: Three Rivers PPO |
$66.20
|
| Rate for Payer: TriWest Veterans Administration |
$50.31
|
| Rate for Payer: United Healthcare Commercial |
$84.30
|
| Rate for Payer: United Healthcare Medicare |
$50.31
|
| Rate for Payer: WINHealth Partners Commercial |
$86.50
|
| Rate for Payer: Wise Provider Network Commercial |
$83.86
|
|
|
CAST TAPE 2" RED DELTA LITE
|
Facility
|
OP
|
$5.97
|
|
| Hospital Charge Code |
2250012
|
|
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" RED DELTA LITE
|
Facility
|
IP
|
$5.97
|
|
| Hospital Charge Code |
2250012
|
|
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" WHITE CONFORMABLE
|
Facility
|
IP
|
$8.81
|
|
| Hospital Charge Code |
2250168
|
|
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" WHITE CONFORMABLE
|
Facility
|
OP
|
$8.81
|
|
| Hospital Charge Code |
2250168
|
|
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" WHITE DELTA LITE
|
Facility
|
OP
|
$5.97
|
|
| Hospital Charge Code |
2250008
|
|
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" WHITE DELTA LITE
|
Facility
|
IP
|
$5.97
|
|
| Hospital Charge Code |
2250008
|
|
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" YELLOW DELTA LITE
|
Facility
|
IP
|
$5.97
|
|
| Hospital Charge Code |
2250113
|
|
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" YELLOW DELTA LITE
|
Facility
|
OP
|
$5.97
|
|
| Hospital Charge Code |
2250113
|
|
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 3" BLACK DELTA LITE
|
Facility
|
OP
|
$7.42
|
|
| Hospital Charge Code |
2250018
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.02 |
| Max. Negotiated Rate |
$7.42 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$7.27
|
| Rate for Payer: Aetna of WY Medicare |
$4.90
|
| Rate for Payer: Altius Commercial |
$7.12
|
| Rate for Payer: Beech Street Commercial |
$7.27
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$7.20
|
| Rate for Payer: Cash Price |
$5.20
|
| Rate for Payer: ChoiceCare Network Commercial |
$7.20
|
| Rate for Payer: Cigna of WY Commercial |
$7.27
|
| Rate for Payer: Entrust Commercial |
$7.05
|
| Rate for Payer: First Choice Health Commercial |
$7.05
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$7.05
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$4.23
|
| Rate for Payer: HealthUtah PPO |
$7.42
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$7.20
|
| Rate for Payer: Multiplan Medicare/VA |
$4.02
|
| Rate for Payer: One Health Plan of WY PPO |
$7.27
|
| Rate for Payer: PacificSource Commercial |
$6.68
|
| Rate for Payer: PHCS PPO |
$7.27
|
| Rate for Payer: Three Rivers PPO |
$5.56
|
| Rate for Payer: TriWest Veterans Administration |
$4.23
|
| Rate for Payer: United Healthcare Commercial |
$7.09
|
| Rate for Payer: United Healthcare Medicare |
$4.23
|
| Rate for Payer: WINHealth Partners Commercial |
$7.27
|
| Rate for Payer: Wise Provider Network Commercial |
$7.05
|
|
|
CAST TAPE 3" BLACK DELTA LITE
|
Facility
|
IP
|
$7.42
|
|
| Hospital Charge Code |
2250018
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.30 |
| Max. Negotiated Rate |
$7.42 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$7.27
|
| Rate for Payer: Aetna of WY Medicare |
$4.75
|
| Rate for Payer: Altius Commercial |
$7.12
|
| Rate for Payer: Beech Street Commercial |
$7.27
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$7.20
|
| Rate for Payer: Cash Price |
$5.20
|
| Rate for Payer: ChoiceCare Network Commercial |
$7.20
|
| Rate for Payer: Cigna of WY Commercial |
$7.27
|
| Rate for Payer: Entrust Commercial |
$7.05
|
| Rate for Payer: First Choice Health Commercial |
$7.05
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$7.05
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$4.53
|
| Rate for Payer: HealthUtah PPO |
$7.42
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$7.20
|
| Rate for Payer: Multiplan Medicare/VA |
$4.30
|
| Rate for Payer: One Health Plan of WY PPO |
$7.27
|
| Rate for Payer: PacificSource Commercial |
$6.68
|
| Rate for Payer: PHCS PPO |
$7.27
|
| Rate for Payer: Three Rivers PPO |
$5.56
|
| Rate for Payer: TriWest Veterans Administration |
$4.53
|
| Rate for Payer: United Healthcare Commercial |
$7.09
|
| Rate for Payer: United Healthcare Medicare |
$4.53
|
| Rate for Payer: WINHealth Partners Commercial |
$7.05
|
| Rate for Payer: Wise Provider Network Commercial |
$7.05
|
|
|
CAST TAPE 3" BLUE DELTA LITE
|
Facility
|
IP
|
$7.42
|
|
| Hospital Charge Code |
2250016
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.30 |
| Max. Negotiated Rate |
$7.42 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$7.27
|
| Rate for Payer: Aetna of WY Medicare |
$4.75
|
| Rate for Payer: Altius Commercial |
$7.12
|
| Rate for Payer: Beech Street Commercial |
$7.27
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$7.20
|
| Rate for Payer: Cash Price |
$5.20
|
| Rate for Payer: ChoiceCare Network Commercial |
$7.20
|
| Rate for Payer: Cigna of WY Commercial |
$7.27
|
| Rate for Payer: Entrust Commercial |
$7.05
|
| Rate for Payer: First Choice Health Commercial |
$7.05
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$7.05
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$4.53
|
| Rate for Payer: HealthUtah PPO |
$7.42
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$7.20
|
| Rate for Payer: Multiplan Medicare/VA |
$4.30
|
| Rate for Payer: One Health Plan of WY PPO |
$7.27
|
| Rate for Payer: PacificSource Commercial |
$6.68
|
| Rate for Payer: PHCS PPO |
$7.27
|
| Rate for Payer: Three Rivers PPO |
$5.56
|
| Rate for Payer: TriWest Veterans Administration |
$4.53
|
| Rate for Payer: United Healthcare Commercial |
$7.09
|
| Rate for Payer: United Healthcare Medicare |
$4.53
|
| Rate for Payer: WINHealth Partners Commercial |
$7.05
|
| Rate for Payer: Wise Provider Network Commercial |
$7.05
|
|
|
CAST TAPE 3" BLUE DELTA LITE
|
Facility
|
OP
|
$7.42
|
|
| Hospital Charge Code |
2250016
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.02 |
| Max. Negotiated Rate |
$7.42 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$7.27
|
| Rate for Payer: Aetna of WY Medicare |
$4.90
|
| Rate for Payer: Altius Commercial |
$7.12
|
| Rate for Payer: Beech Street Commercial |
$7.27
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$7.20
|
| Rate for Payer: Cash Price |
$5.20
|
| Rate for Payer: ChoiceCare Network Commercial |
$7.20
|
| Rate for Payer: Cigna of WY Commercial |
$7.27
|
| Rate for Payer: Entrust Commercial |
$7.05
|
| Rate for Payer: First Choice Health Commercial |
$7.05
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$7.05
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$4.23
|
| Rate for Payer: HealthUtah PPO |
$7.42
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$7.20
|
| Rate for Payer: Multiplan Medicare/VA |
$4.02
|
| Rate for Payer: One Health Plan of WY PPO |
$7.27
|
| Rate for Payer: PacificSource Commercial |
$6.68
|
| Rate for Payer: PHCS PPO |
$7.27
|
| Rate for Payer: Three Rivers PPO |
$5.56
|
| Rate for Payer: TriWest Veterans Administration |
$4.23
|
| Rate for Payer: United Healthcare Commercial |
$7.09
|
| Rate for Payer: United Healthcare Medicare |
$4.23
|
| Rate for Payer: WINHealth Partners Commercial |
$7.27
|
| Rate for Payer: Wise Provider Network Commercial |
$7.05
|
|
|
CAST TAPE 3" CAMOUFLAGE
|
Facility
|
OP
|
$17.14
|
|
| Hospital Charge Code |
2250067
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$9.28 |
| Max. Negotiated Rate |
$17.14 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$16.80
|
| Rate for Payer: Aetna of WY Medicare |
$11.31
|
| Rate for Payer: Altius Commercial |
$16.45
|
| Rate for Payer: Beech Street Commercial |
$16.80
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$16.63
|
| Rate for Payer: Cash Price |
$12.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$16.63
|
| Rate for Payer: Cigna of WY Commercial |
$16.80
|
| Rate for Payer: Entrust Commercial |
$16.28
|
| Rate for Payer: First Choice Health Commercial |
$16.28
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$16.28
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$9.77
|
| Rate for Payer: HealthUtah PPO |
$17.14
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$16.63
|
| Rate for Payer: Multiplan Medicare/VA |
$9.28
|
| Rate for Payer: One Health Plan of WY PPO |
$16.80
|
| Rate for Payer: PacificSource Commercial |
$15.43
|
| Rate for Payer: PHCS PPO |
$16.80
|
| Rate for Payer: Three Rivers PPO |
$12.86
|
| Rate for Payer: TriWest Veterans Administration |
$9.77
|
| Rate for Payer: United Healthcare Commercial |
$16.37
|
| Rate for Payer: United Healthcare Medicare |
$9.77
|
| Rate for Payer: WINHealth Partners Commercial |
$16.80
|
| Rate for Payer: Wise Provider Network Commercial |
$16.28
|
|
|
CAST TAPE 3" CAMOUFLAGE
|
Facility
|
IP
|
$17.14
|
|
| Hospital Charge Code |
2250067
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$9.93 |
| Max. Negotiated Rate |
$17.14 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$16.80
|
| Rate for Payer: Aetna of WY Medicare |
$10.97
|
| Rate for Payer: Altius Commercial |
$16.45
|
| Rate for Payer: Beech Street Commercial |
$16.80
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$16.63
|
| Rate for Payer: Cash Price |
$12.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$16.63
|
| Rate for Payer: Cigna of WY Commercial |
$16.80
|
| Rate for Payer: Entrust Commercial |
$16.28
|
| Rate for Payer: First Choice Health Commercial |
$16.28
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$16.28
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$10.46
|
| Rate for Payer: HealthUtah PPO |
$17.14
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$16.63
|
| Rate for Payer: Multiplan Medicare/VA |
$9.93
|
| Rate for Payer: One Health Plan of WY PPO |
$16.80
|
| Rate for Payer: PacificSource Commercial |
$15.43
|
| Rate for Payer: PHCS PPO |
$16.80
|
| Rate for Payer: Three Rivers PPO |
$12.86
|
| Rate for Payer: TriWest Veterans Administration |
$10.46
|
| Rate for Payer: United Healthcare Commercial |
$16.37
|
| Rate for Payer: United Healthcare Medicare |
$10.46
|
| Rate for Payer: WINHealth Partners Commercial |
$16.28
|
| Rate for Payer: Wise Provider Network Commercial |
$16.28
|
|
|
CAST TAPE 3" PASTEL RAINBOW
|
Facility
|
OP
|
$17.14
|
|
| Hospital Charge Code |
2250068
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$9.28 |
| Max. Negotiated Rate |
$17.14 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$16.80
|
| Rate for Payer: Aetna of WY Medicare |
$11.31
|
| Rate for Payer: Altius Commercial |
$16.45
|
| Rate for Payer: Beech Street Commercial |
$16.80
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$16.63
|
| Rate for Payer: Cash Price |
$12.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$16.63
|
| Rate for Payer: Cigna of WY Commercial |
$16.80
|
| Rate for Payer: Entrust Commercial |
$16.28
|
| Rate for Payer: First Choice Health Commercial |
$16.28
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$16.28
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$9.77
|
| Rate for Payer: HealthUtah PPO |
$17.14
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$16.63
|
| Rate for Payer: Multiplan Medicare/VA |
$9.28
|
| Rate for Payer: One Health Plan of WY PPO |
$16.80
|
| Rate for Payer: PacificSource Commercial |
$15.43
|
| Rate for Payer: PHCS PPO |
$16.80
|
| Rate for Payer: Three Rivers PPO |
$12.86
|
| Rate for Payer: TriWest Veterans Administration |
$9.77
|
| Rate for Payer: United Healthcare Commercial |
$16.37
|
| Rate for Payer: United Healthcare Medicare |
$9.77
|
| Rate for Payer: WINHealth Partners Commercial |
$16.80
|
| Rate for Payer: Wise Provider Network Commercial |
$16.28
|
|
|
CAST TAPE 3" PASTEL RAINBOW
|
Facility
|
IP
|
$17.14
|
|
| Hospital Charge Code |
2250068
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$9.93 |
| Max. Negotiated Rate |
$17.14 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$16.80
|
| Rate for Payer: Aetna of WY Medicare |
$10.97
|
| Rate for Payer: Altius Commercial |
$16.45
|
| Rate for Payer: Beech Street Commercial |
$16.80
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$16.63
|
| Rate for Payer: Cash Price |
$12.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$16.63
|
| Rate for Payer: Cigna of WY Commercial |
$16.80
|
| Rate for Payer: Entrust Commercial |
$16.28
|
| Rate for Payer: First Choice Health Commercial |
$16.28
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$16.28
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$10.46
|
| Rate for Payer: HealthUtah PPO |
$17.14
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$16.63
|
| Rate for Payer: Multiplan Medicare/VA |
$9.93
|
| Rate for Payer: One Health Plan of WY PPO |
$16.80
|
| Rate for Payer: PacificSource Commercial |
$15.43
|
| Rate for Payer: PHCS PPO |
$16.80
|
| Rate for Payer: Three Rivers PPO |
$12.86
|
| Rate for Payer: TriWest Veterans Administration |
$10.46
|
| Rate for Payer: United Healthcare Commercial |
$16.37
|
| Rate for Payer: United Healthcare Medicare |
$10.46
|
| Rate for Payer: WINHealth Partners Commercial |
$16.28
|
| Rate for Payer: Wise Provider Network Commercial |
$16.28
|
|
|
CAST TAPE 3" PINK DELTA LITE
|
Facility
|
IP
|
$7.42
|
|
| Hospital Charge Code |
2250019
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4.30 |
| Max. Negotiated Rate |
$7.42 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$7.27
|
| Rate for Payer: Aetna of WY Medicare |
$4.75
|
| Rate for Payer: Altius Commercial |
$7.12
|
| Rate for Payer: Beech Street Commercial |
$7.27
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$7.20
|
| Rate for Payer: Cash Price |
$5.20
|
| Rate for Payer: ChoiceCare Network Commercial |
$7.20
|
| Rate for Payer: Cigna of WY Commercial |
$7.27
|
| Rate for Payer: Entrust Commercial |
$7.05
|
| Rate for Payer: First Choice Health Commercial |
$7.05
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$7.05
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$4.53
|
| Rate for Payer: HealthUtah PPO |
$7.42
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$7.20
|
| Rate for Payer: Multiplan Medicare/VA |
$4.30
|
| Rate for Payer: One Health Plan of WY PPO |
$7.27
|
| Rate for Payer: PacificSource Commercial |
$6.68
|
| Rate for Payer: PHCS PPO |
$7.27
|
| Rate for Payer: Three Rivers PPO |
$5.56
|
| Rate for Payer: TriWest Veterans Administration |
$4.53
|
| Rate for Payer: United Healthcare Commercial |
$7.09
|
| Rate for Payer: United Healthcare Medicare |
$4.53
|
| Rate for Payer: WINHealth Partners Commercial |
$7.05
|
| Rate for Payer: Wise Provider Network Commercial |
$7.05
|
|
|
CAST TAPE 3" PINK DELTA LITE
|
Facility
|
OP
|
$7.42
|
|
| Hospital Charge Code |
2250019
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4.02 |
| Max. Negotiated Rate |
$7.42 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$7.27
|
| Rate for Payer: Aetna of WY Medicare |
$4.90
|
| Rate for Payer: Altius Commercial |
$7.12
|
| Rate for Payer: Beech Street Commercial |
$7.27
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$7.20
|
| Rate for Payer: Cash Price |
$5.20
|
| Rate for Payer: ChoiceCare Network Commercial |
$7.20
|
| Rate for Payer: Cigna of WY Commercial |
$7.27
|
| Rate for Payer: Entrust Commercial |
$7.05
|
| Rate for Payer: First Choice Health Commercial |
$7.05
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$7.05
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$4.23
|
| Rate for Payer: HealthUtah PPO |
$7.42
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$7.20
|
| Rate for Payer: Multiplan Medicare/VA |
$4.02
|
| Rate for Payer: One Health Plan of WY PPO |
$7.27
|
| Rate for Payer: PacificSource Commercial |
$6.68
|
| Rate for Payer: PHCS PPO |
$7.27
|
| Rate for Payer: Three Rivers PPO |
$5.56
|
| Rate for Payer: TriWest Veterans Administration |
$4.23
|
| Rate for Payer: United Healthcare Commercial |
$7.09
|
| Rate for Payer: United Healthcare Medicare |
$4.23
|
| Rate for Payer: WINHealth Partners Commercial |
$7.27
|
| Rate for Payer: Wise Provider Network Commercial |
$7.05
|
|
|
CAST TAPE 3" PURPLE DELTA LITE
|
Facility
|
IP
|
$7.42
|
|
| Hospital Charge Code |
2250021
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.30 |
| Max. Negotiated Rate |
$7.42 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$7.27
|
| Rate for Payer: Aetna of WY Medicare |
$4.75
|
| Rate for Payer: Altius Commercial |
$7.12
|
| Rate for Payer: Beech Street Commercial |
$7.27
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$7.20
|
| Rate for Payer: Cash Price |
$5.20
|
| Rate for Payer: ChoiceCare Network Commercial |
$7.20
|
| Rate for Payer: Cigna of WY Commercial |
$7.27
|
| Rate for Payer: Entrust Commercial |
$7.05
|
| Rate for Payer: First Choice Health Commercial |
$7.05
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$7.05
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$4.53
|
| Rate for Payer: HealthUtah PPO |
$7.42
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$7.20
|
| Rate for Payer: Multiplan Medicare/VA |
$4.30
|
| Rate for Payer: One Health Plan of WY PPO |
$7.27
|
| Rate for Payer: PacificSource Commercial |
$6.68
|
| Rate for Payer: PHCS PPO |
$7.27
|
| Rate for Payer: Three Rivers PPO |
$5.56
|
| Rate for Payer: TriWest Veterans Administration |
$4.53
|
| Rate for Payer: United Healthcare Commercial |
$7.09
|
| Rate for Payer: United Healthcare Medicare |
$4.53
|
| Rate for Payer: WINHealth Partners Commercial |
$7.05
|
| Rate for Payer: Wise Provider Network Commercial |
$7.05
|
|
|
CAST TAPE 3" PURPLE DELTA LITE
|
Facility
|
OP
|
$7.42
|
|
| Hospital Charge Code |
2250021
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.02 |
| Max. Negotiated Rate |
$7.42 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$7.27
|
| Rate for Payer: Aetna of WY Medicare |
$4.90
|
| Rate for Payer: Altius Commercial |
$7.12
|
| Rate for Payer: Beech Street Commercial |
$7.27
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$7.20
|
| Rate for Payer: Cash Price |
$5.20
|
| Rate for Payer: ChoiceCare Network Commercial |
$7.20
|
| Rate for Payer: Cigna of WY Commercial |
$7.27
|
| Rate for Payer: Entrust Commercial |
$7.05
|
| Rate for Payer: First Choice Health Commercial |
$7.05
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$7.05
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$4.23
|
| Rate for Payer: HealthUtah PPO |
$7.42
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$7.20
|
| Rate for Payer: Multiplan Medicare/VA |
$4.02
|
| Rate for Payer: One Health Plan of WY PPO |
$7.27
|
| Rate for Payer: PacificSource Commercial |
$6.68
|
| Rate for Payer: PHCS PPO |
$7.27
|
| Rate for Payer: Three Rivers PPO |
$5.56
|
| Rate for Payer: TriWest Veterans Administration |
$4.23
|
| Rate for Payer: United Healthcare Commercial |
$7.09
|
| Rate for Payer: United Healthcare Medicare |
$4.23
|
| Rate for Payer: WINHealth Partners Commercial |
$7.27
|
| Rate for Payer: Wise Provider Network Commercial |
$7.05
|
|
