|
CATH IV 18GX1.25 ACUVANCE 3355
|
Facility
|
OP
|
$6.06
|
|
| Hospital Charge Code |
2350006
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3.28 |
| Max. Negotiated Rate |
$6.06 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$5.94
|
| Rate for Payer: Aetna of WY Medicare |
$4.00
|
| Rate for Payer: Altius Commercial |
$5.82
|
| Rate for Payer: Beech Street Commercial |
$5.94
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$5.88
|
| Rate for Payer: Cash Price |
$4.24
|
| Rate for Payer: ChoiceCare Network Commercial |
$5.88
|
| Rate for Payer: Cigna of WY Commercial |
$5.94
|
| Rate for Payer: Entrust Commercial |
$5.76
|
| Rate for Payer: First Choice Health Commercial |
$5.76
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$5.76
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$3.45
|
| Rate for Payer: HealthUtah PPO |
$6.06
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$5.88
|
| Rate for Payer: Multiplan Medicare/VA |
$3.28
|
| Rate for Payer: One Health Plan of WY PPO |
$5.94
|
| Rate for Payer: PacificSource Commercial |
$5.45
|
| Rate for Payer: PHCS PPO |
$5.94
|
| Rate for Payer: Three Rivers PPO |
$4.54
|
| Rate for Payer: TriWest Veterans Administration |
$3.45
|
| Rate for Payer: United Healthcare Commercial |
$5.79
|
| Rate for Payer: United Healthcare Medicare |
$3.45
|
| Rate for Payer: WINHealth Partners Commercial |
$5.94
|
| Rate for Payer: Wise Provider Network Commercial |
$5.76
|
|
|
CATH IV 18GX1.25 ACUVANCE 3355
|
Facility
|
IP
|
$6.06
|
|
| Hospital Charge Code |
2350006
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3.51 |
| Max. Negotiated Rate |
$6.06 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$5.94
|
| Rate for Payer: Aetna of WY Medicare |
$3.88
|
| Rate for Payer: Altius Commercial |
$5.82
|
| Rate for Payer: Beech Street Commercial |
$5.94
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$5.88
|
| Rate for Payer: Cash Price |
$4.24
|
| Rate for Payer: ChoiceCare Network Commercial |
$5.88
|
| Rate for Payer: Cigna of WY Commercial |
$5.94
|
| Rate for Payer: Entrust Commercial |
$5.76
|
| Rate for Payer: First Choice Health Commercial |
$5.76
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$5.76
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$3.70
|
| Rate for Payer: HealthUtah PPO |
$6.06
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$5.88
|
| Rate for Payer: Multiplan Medicare/VA |
$3.51
|
| Rate for Payer: One Health Plan of WY PPO |
$5.94
|
| Rate for Payer: PacificSource Commercial |
$5.45
|
| Rate for Payer: PHCS PPO |
$5.94
|
| Rate for Payer: Three Rivers PPO |
$4.54
|
| Rate for Payer: TriWest Veterans Administration |
$3.70
|
| Rate for Payer: United Healthcare Commercial |
$5.79
|
| Rate for Payer: United Healthcare Medicare |
$3.70
|
| Rate for Payer: WINHealth Partners Commercial |
$5.76
|
| Rate for Payer: Wise Provider Network Commercial |
$5.76
|
|
|
CATH IV 20G 1" NEXIVA 383536
|
Facility
|
OP
|
$15.76
|
|
| Hospital Charge Code |
2350043
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$8.53 |
| Max. Negotiated Rate |
$15.76 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$15.44
|
| Rate for Payer: Aetna of WY Medicare |
$10.40
|
| Rate for Payer: Altius Commercial |
$15.13
|
| Rate for Payer: Beech Street Commercial |
$15.44
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$15.29
|
| Rate for Payer: Cash Price |
$11.03
|
| Rate for Payer: ChoiceCare Network Commercial |
$15.29
|
| Rate for Payer: Cigna of WY Commercial |
$15.44
|
| Rate for Payer: Entrust Commercial |
$14.97
|
| Rate for Payer: First Choice Health Commercial |
$14.97
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$14.97
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$8.98
|
| Rate for Payer: HealthUtah PPO |
$15.76
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$15.29
|
| Rate for Payer: Multiplan Medicare/VA |
$8.53
|
| Rate for Payer: One Health Plan of WY PPO |
$15.44
|
| Rate for Payer: PacificSource Commercial |
$14.18
|
| Rate for Payer: PHCS PPO |
$15.44
|
| Rate for Payer: Three Rivers PPO |
$11.82
|
| Rate for Payer: TriWest Veterans Administration |
$8.98
|
| Rate for Payer: United Healthcare Commercial |
$15.05
|
| Rate for Payer: United Healthcare Medicare |
$8.98
|
| Rate for Payer: WINHealth Partners Commercial |
$15.44
|
| Rate for Payer: Wise Provider Network Commercial |
$14.97
|
|
|
CATH IV 20G 1" NEXIVA 383536
|
Facility
|
IP
|
$15.76
|
|
| Hospital Charge Code |
2350043
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$9.13 |
| Max. Negotiated Rate |
$15.76 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$15.44
|
| Rate for Payer: Aetna of WY Medicare |
$10.09
|
| Rate for Payer: Altius Commercial |
$15.13
|
| Rate for Payer: Beech Street Commercial |
$15.44
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$15.29
|
| Rate for Payer: Cash Price |
$11.03
|
| Rate for Payer: ChoiceCare Network Commercial |
$15.29
|
| Rate for Payer: Cigna of WY Commercial |
$15.44
|
| Rate for Payer: Entrust Commercial |
$14.97
|
| Rate for Payer: First Choice Health Commercial |
$14.97
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$14.97
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$9.61
|
| Rate for Payer: HealthUtah PPO |
$15.76
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$15.29
|
| Rate for Payer: Multiplan Medicare/VA |
$9.13
|
| Rate for Payer: One Health Plan of WY PPO |
$15.44
|
| Rate for Payer: PacificSource Commercial |
$14.18
|
| Rate for Payer: PHCS PPO |
$15.44
|
| Rate for Payer: Three Rivers PPO |
$11.82
|
| Rate for Payer: TriWest Veterans Administration |
$9.61
|
| Rate for Payer: United Healthcare Commercial |
$15.05
|
| Rate for Payer: United Healthcare Medicare |
$9.61
|
| Rate for Payer: WINHealth Partners Commercial |
$14.97
|
| Rate for Payer: Wise Provider Network Commercial |
$14.97
|
|
|
CATH IV 20GX1 ACUVANCE 3357
|
Facility
|
IP
|
$6.06
|
|
| Hospital Charge Code |
2350007
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3.51 |
| Max. Negotiated Rate |
$6.06 |
| Rate for Payer: United Healthcare Commercial |
$5.79
|
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$5.94
|
| Rate for Payer: Aetna of WY Medicare |
$3.88
|
| Rate for Payer: Altius Commercial |
$5.82
|
| Rate for Payer: Beech Street Commercial |
$5.94
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$5.88
|
| Rate for Payer: Cash Price |
$4.24
|
| Rate for Payer: ChoiceCare Network Commercial |
$5.88
|
| Rate for Payer: Cigna of WY Commercial |
$5.94
|
| Rate for Payer: Entrust Commercial |
$5.76
|
| Rate for Payer: First Choice Health Commercial |
$5.76
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$5.76
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$3.70
|
| Rate for Payer: HealthUtah PPO |
$6.06
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$5.88
|
| Rate for Payer: Multiplan Medicare/VA |
$3.51
|
| Rate for Payer: One Health Plan of WY PPO |
$5.94
|
| Rate for Payer: PacificSource Commercial |
$5.45
|
| Rate for Payer: PHCS PPO |
$5.94
|
| Rate for Payer: Three Rivers PPO |
$4.54
|
| Rate for Payer: TriWest Veterans Administration |
$3.70
|
| Rate for Payer: United Healthcare Medicare |
$3.70
|
| Rate for Payer: WINHealth Partners Commercial |
$5.76
|
| Rate for Payer: Wise Provider Network Commercial |
$5.76
|
|
|
CATH IV 20GX1 ACUVANCE 3357
|
Facility
|
OP
|
$6.06
|
|
| Hospital Charge Code |
2350007
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3.28 |
| Max. Negotiated Rate |
$6.06 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$5.94
|
| Rate for Payer: Aetna of WY Medicare |
$4.00
|
| Rate for Payer: Altius Commercial |
$5.82
|
| Rate for Payer: Beech Street Commercial |
$5.94
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$5.88
|
| Rate for Payer: Cash Price |
$4.24
|
| Rate for Payer: ChoiceCare Network Commercial |
$5.88
|
| Rate for Payer: Cigna of WY Commercial |
$5.94
|
| Rate for Payer: Entrust Commercial |
$5.76
|
| Rate for Payer: First Choice Health Commercial |
$5.76
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$5.76
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$3.45
|
| Rate for Payer: HealthUtah PPO |
$6.06
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$5.88
|
| Rate for Payer: Multiplan Medicare/VA |
$3.28
|
| Rate for Payer: One Health Plan of WY PPO |
$5.94
|
| Rate for Payer: PacificSource Commercial |
$5.45
|
| Rate for Payer: PHCS PPO |
$5.94
|
| Rate for Payer: Three Rivers PPO |
$4.54
|
| Rate for Payer: TriWest Veterans Administration |
$3.45
|
| Rate for Payer: United Healthcare Commercial |
$5.79
|
| Rate for Payer: United Healthcare Medicare |
$3.45
|
| Rate for Payer: WINHealth Partners Commercial |
$5.94
|
| Rate for Payer: Wise Provider Network Commercial |
$5.76
|
|
|
CATH IV 22G 1" JELCO 3260
|
Facility
|
IP
|
$6.12
|
|
| Hospital Charge Code |
2350077
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3.55 |
| Max. Negotiated Rate |
$6.12 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$6.00
|
| Rate for Payer: Aetna of WY Medicare |
$3.92
|
| Rate for Payer: Altius Commercial |
$5.88
|
| Rate for Payer: Beech Street Commercial |
$6.00
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$5.94
|
| Rate for Payer: Cash Price |
$4.29
|
| Rate for Payer: ChoiceCare Network Commercial |
$5.94
|
| Rate for Payer: Cigna of WY Commercial |
$6.00
|
| Rate for Payer: Entrust Commercial |
$5.81
|
| Rate for Payer: First Choice Health Commercial |
$5.81
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$5.81
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$3.73
|
| Rate for Payer: HealthUtah PPO |
$6.12
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$5.94
|
| Rate for Payer: Multiplan Medicare/VA |
$3.55
|
| Rate for Payer: One Health Plan of WY PPO |
$6.00
|
| Rate for Payer: PacificSource Commercial |
$5.51
|
| Rate for Payer: PHCS PPO |
$6.00
|
| Rate for Payer: Three Rivers PPO |
$4.59
|
| Rate for Payer: TriWest Veterans Administration |
$3.73
|
| Rate for Payer: United Healthcare Commercial |
$5.84
|
| Rate for Payer: United Healthcare Medicare |
$3.73
|
| Rate for Payer: WINHealth Partners Commercial |
$5.81
|
| Rate for Payer: Wise Provider Network Commercial |
$5.81
|
|
|
CATH IV 22G 1" JELCO 3260
|
Facility
|
OP
|
$6.12
|
|
| Hospital Charge Code |
2350077
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3.31 |
| Max. Negotiated Rate |
$6.12 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$6.00
|
| Rate for Payer: Aetna of WY Medicare |
$4.04
|
| Rate for Payer: Altius Commercial |
$5.88
|
| Rate for Payer: Beech Street Commercial |
$6.00
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$5.94
|
| Rate for Payer: Cash Price |
$4.29
|
| Rate for Payer: ChoiceCare Network Commercial |
$5.94
|
| Rate for Payer: Cigna of WY Commercial |
$6.00
|
| Rate for Payer: Entrust Commercial |
$5.81
|
| Rate for Payer: First Choice Health Commercial |
$5.81
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$5.81
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$3.49
|
| Rate for Payer: HealthUtah PPO |
$6.12
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$5.94
|
| Rate for Payer: Multiplan Medicare/VA |
$3.31
|
| Rate for Payer: One Health Plan of WY PPO |
$6.00
|
| Rate for Payer: PacificSource Commercial |
$5.51
|
| Rate for Payer: PHCS PPO |
$6.00
|
| Rate for Payer: Three Rivers PPO |
$4.59
|
| Rate for Payer: TriWest Veterans Administration |
$3.49
|
| Rate for Payer: United Healthcare Commercial |
$5.84
|
| Rate for Payer: United Healthcare Medicare |
$3.49
|
| Rate for Payer: WINHealth Partners Commercial |
$6.00
|
| Rate for Payer: Wise Provider Network Commercial |
$5.81
|
|
|
CATH IV 22G 1" NEXIVA 383532
|
Facility
|
IP
|
$15.76
|
|
| Hospital Charge Code |
2350042
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$9.13 |
| Max. Negotiated Rate |
$15.76 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$15.44
|
| Rate for Payer: Aetna of WY Medicare |
$10.09
|
| Rate for Payer: Altius Commercial |
$15.13
|
| Rate for Payer: Beech Street Commercial |
$15.44
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$15.29
|
| Rate for Payer: Cash Price |
$11.03
|
| Rate for Payer: ChoiceCare Network Commercial |
$15.29
|
| Rate for Payer: Cigna of WY Commercial |
$15.44
|
| Rate for Payer: Entrust Commercial |
$14.97
|
| Rate for Payer: First Choice Health Commercial |
$14.97
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$14.97
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$9.61
|
| Rate for Payer: HealthUtah PPO |
$15.76
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$15.29
|
| Rate for Payer: Multiplan Medicare/VA |
$9.13
|
| Rate for Payer: One Health Plan of WY PPO |
$15.44
|
| Rate for Payer: PacificSource Commercial |
$14.18
|
| Rate for Payer: PHCS PPO |
$15.44
|
| Rate for Payer: Three Rivers PPO |
$11.82
|
| Rate for Payer: TriWest Veterans Administration |
$9.61
|
| Rate for Payer: United Healthcare Commercial |
$15.05
|
| Rate for Payer: United Healthcare Medicare |
$9.61
|
| Rate for Payer: WINHealth Partners Commercial |
$14.97
|
| Rate for Payer: Wise Provider Network Commercial |
$14.97
|
|
|
CATH IV 22G 1" NEXIVA 383532
|
Facility
|
OP
|
$15.76
|
|
| Hospital Charge Code |
2350042
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$8.53 |
| Max. Negotiated Rate |
$15.76 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$15.44
|
| Rate for Payer: Aetna of WY Medicare |
$10.40
|
| Rate for Payer: Altius Commercial |
$15.13
|
| Rate for Payer: Beech Street Commercial |
$15.44
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$15.29
|
| Rate for Payer: Cash Price |
$11.03
|
| Rate for Payer: ChoiceCare Network Commercial |
$15.29
|
| Rate for Payer: Cigna of WY Commercial |
$15.44
|
| Rate for Payer: Entrust Commercial |
$14.97
|
| Rate for Payer: First Choice Health Commercial |
$14.97
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$14.97
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$8.98
|
| Rate for Payer: HealthUtah PPO |
$15.76
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$15.29
|
| Rate for Payer: Multiplan Medicare/VA |
$8.53
|
| Rate for Payer: One Health Plan of WY PPO |
$15.44
|
| Rate for Payer: PacificSource Commercial |
$14.18
|
| Rate for Payer: PHCS PPO |
$15.44
|
| Rate for Payer: Three Rivers PPO |
$11.82
|
| Rate for Payer: TriWest Veterans Administration |
$8.98
|
| Rate for Payer: United Healthcare Commercial |
$15.05
|
| Rate for Payer: United Healthcare Medicare |
$8.98
|
| Rate for Payer: WINHealth Partners Commercial |
$15.44
|
| Rate for Payer: Wise Provider Network Commercial |
$14.97
|
|
|
CATH IV 22GX1 ACUVANCE 3350
|
Facility
|
IP
|
$6.06
|
|
| Hospital Charge Code |
2350008
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3.51 |
| Max. Negotiated Rate |
$6.06 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$5.94
|
| Rate for Payer: Aetna of WY Medicare |
$3.88
|
| Rate for Payer: Altius Commercial |
$5.82
|
| Rate for Payer: Beech Street Commercial |
$5.94
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$5.88
|
| Rate for Payer: Cash Price |
$4.24
|
| Rate for Payer: ChoiceCare Network Commercial |
$5.88
|
| Rate for Payer: Cigna of WY Commercial |
$5.94
|
| Rate for Payer: Entrust Commercial |
$5.76
|
| Rate for Payer: First Choice Health Commercial |
$5.76
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$5.76
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$3.70
|
| Rate for Payer: HealthUtah PPO |
$6.06
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$5.88
|
| Rate for Payer: Multiplan Medicare/VA |
$3.51
|
| Rate for Payer: One Health Plan of WY PPO |
$5.94
|
| Rate for Payer: PacificSource Commercial |
$5.45
|
| Rate for Payer: PHCS PPO |
$5.94
|
| Rate for Payer: Three Rivers PPO |
$4.54
|
| Rate for Payer: TriWest Veterans Administration |
$3.70
|
| Rate for Payer: United Healthcare Commercial |
$5.79
|
| Rate for Payer: United Healthcare Medicare |
$3.70
|
| Rate for Payer: WINHealth Partners Commercial |
$5.76
|
| Rate for Payer: Wise Provider Network Commercial |
$5.76
|
|
|
CATH IV 22GX1 ACUVANCE 3350
|
Facility
|
OP
|
$6.06
|
|
| Hospital Charge Code |
2350008
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3.28 |
| Max. Negotiated Rate |
$6.06 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$5.94
|
| Rate for Payer: Aetna of WY Medicare |
$4.00
|
| Rate for Payer: Altius Commercial |
$5.82
|
| Rate for Payer: Beech Street Commercial |
$5.94
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$5.88
|
| Rate for Payer: Cash Price |
$4.24
|
| Rate for Payer: ChoiceCare Network Commercial |
$5.88
|
| Rate for Payer: Cigna of WY Commercial |
$5.94
|
| Rate for Payer: Entrust Commercial |
$5.76
|
| Rate for Payer: First Choice Health Commercial |
$5.76
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$5.76
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$3.45
|
| Rate for Payer: HealthUtah PPO |
$6.06
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$5.88
|
| Rate for Payer: Multiplan Medicare/VA |
$3.28
|
| Rate for Payer: One Health Plan of WY PPO |
$5.94
|
| Rate for Payer: PacificSource Commercial |
$5.45
|
| Rate for Payer: PHCS PPO |
$5.94
|
| Rate for Payer: Three Rivers PPO |
$4.54
|
| Rate for Payer: TriWest Veterans Administration |
$3.45
|
| Rate for Payer: United Healthcare Commercial |
$5.79
|
| Rate for Payer: United Healthcare Medicare |
$3.45
|
| Rate for Payer: WINHealth Partners Commercial |
$5.94
|
| Rate for Payer: Wise Provider Network Commercial |
$5.76
|
|
|
CATH IV 24G 5/8" JELCO 3263
|
Facility
|
OP
|
$6.20
|
|
| Hospital Charge Code |
2350078
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.36 |
| Max. Negotiated Rate |
$6.20 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$6.08
|
| Rate for Payer: Aetna of WY Medicare |
$4.09
|
| Rate for Payer: Altius Commercial |
$5.95
|
| Rate for Payer: Beech Street Commercial |
$6.08
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$6.01
|
| Rate for Payer: Cash Price |
$4.34
|
| Rate for Payer: ChoiceCare Network Commercial |
$6.01
|
| Rate for Payer: Cigna of WY Commercial |
$6.08
|
| Rate for Payer: Entrust Commercial |
$5.89
|
| Rate for Payer: First Choice Health Commercial |
$5.89
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$5.89
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$3.53
|
| Rate for Payer: HealthUtah PPO |
$6.20
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$6.01
|
| Rate for Payer: Multiplan Medicare/VA |
$3.36
|
| Rate for Payer: One Health Plan of WY PPO |
$6.08
|
| Rate for Payer: PacificSource Commercial |
$5.58
|
| Rate for Payer: PHCS PPO |
$6.08
|
| Rate for Payer: Three Rivers PPO |
$4.65
|
| Rate for Payer: TriWest Veterans Administration |
$3.53
|
| Rate for Payer: United Healthcare Commercial |
$5.92
|
| Rate for Payer: United Healthcare Medicare |
$3.53
|
| Rate for Payer: WINHealth Partners Commercial |
$6.08
|
| Rate for Payer: Wise Provider Network Commercial |
$5.89
|
|
|
CATH IV 24G 5/8" JELCO 3263
|
Facility
|
IP
|
$6.20
|
|
| Hospital Charge Code |
2350078
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.59 |
| Max. Negotiated Rate |
$6.20 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$6.08
|
| Rate for Payer: Aetna of WY Medicare |
$3.97
|
| Rate for Payer: Altius Commercial |
$5.95
|
| Rate for Payer: Beech Street Commercial |
$6.08
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$6.01
|
| Rate for Payer: Cash Price |
$4.34
|
| Rate for Payer: ChoiceCare Network Commercial |
$6.01
|
| Rate for Payer: Cigna of WY Commercial |
$6.08
|
| Rate for Payer: Entrust Commercial |
$5.89
|
| Rate for Payer: First Choice Health Commercial |
$5.89
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$5.89
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$3.78
|
| Rate for Payer: HealthUtah PPO |
$6.20
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$6.01
|
| Rate for Payer: Multiplan Medicare/VA |
$3.59
|
| Rate for Payer: One Health Plan of WY PPO |
$6.08
|
| Rate for Payer: PacificSource Commercial |
$5.58
|
| Rate for Payer: PHCS PPO |
$6.08
|
| Rate for Payer: Three Rivers PPO |
$4.65
|
| Rate for Payer: TriWest Veterans Administration |
$3.78
|
| Rate for Payer: United Healthcare Commercial |
$5.92
|
| Rate for Payer: United Healthcare Medicare |
$3.78
|
| Rate for Payer: WINHealth Partners Commercial |
$5.89
|
| Rate for Payer: Wise Provider Network Commercial |
$5.89
|
|
|
CATH IV 24G .75" NEXIVA
|
Facility
|
IP
|
$15.92
|
|
| Hospital Charge Code |
2350055
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$9.23 |
| Max. Negotiated Rate |
$15.92 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$15.60
|
| Rate for Payer: Aetna of WY Medicare |
$10.19
|
| Rate for Payer: Altius Commercial |
$15.28
|
| Rate for Payer: Beech Street Commercial |
$15.60
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$15.44
|
| Rate for Payer: Cash Price |
$11.14
|
| Rate for Payer: ChoiceCare Network Commercial |
$15.44
|
| Rate for Payer: Cigna of WY Commercial |
$15.60
|
| Rate for Payer: Entrust Commercial |
$15.12
|
| Rate for Payer: First Choice Health Commercial |
$15.12
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$15.12
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$9.71
|
| Rate for Payer: HealthUtah PPO |
$15.92
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$15.44
|
| Rate for Payer: Multiplan Medicare/VA |
$9.23
|
| Rate for Payer: One Health Plan of WY PPO |
$15.60
|
| Rate for Payer: PacificSource Commercial |
$14.33
|
| Rate for Payer: PHCS PPO |
$15.60
|
| Rate for Payer: Three Rivers PPO |
$11.94
|
| Rate for Payer: TriWest Veterans Administration |
$9.71
|
| Rate for Payer: United Healthcare Commercial |
$15.20
|
| Rate for Payer: United Healthcare Medicare |
$9.71
|
| Rate for Payer: WINHealth Partners Commercial |
$15.12
|
| Rate for Payer: Wise Provider Network Commercial |
$15.12
|
|
|
CATH IV 24G .75" NEXIVA
|
Facility
|
OP
|
$15.92
|
|
| Hospital Charge Code |
2350055
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$8.62 |
| Max. Negotiated Rate |
$15.92 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$15.60
|
| Rate for Payer: Aetna of WY Medicare |
$10.51
|
| Rate for Payer: Altius Commercial |
$15.28
|
| Rate for Payer: Beech Street Commercial |
$15.60
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$15.44
|
| Rate for Payer: Cash Price |
$11.14
|
| Rate for Payer: ChoiceCare Network Commercial |
$15.44
|
| Rate for Payer: Cigna of WY Commercial |
$15.60
|
| Rate for Payer: Entrust Commercial |
$15.12
|
| Rate for Payer: First Choice Health Commercial |
$15.12
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$15.12
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$9.07
|
| Rate for Payer: HealthUtah PPO |
$15.92
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$15.44
|
| Rate for Payer: Multiplan Medicare/VA |
$8.62
|
| Rate for Payer: One Health Plan of WY PPO |
$15.60
|
| Rate for Payer: PacificSource Commercial |
$14.33
|
| Rate for Payer: PHCS PPO |
$15.60
|
| Rate for Payer: Three Rivers PPO |
$11.94
|
| Rate for Payer: TriWest Veterans Administration |
$9.07
|
| Rate for Payer: United Healthcare Commercial |
$15.20
|
| Rate for Payer: United Healthcare Medicare |
$9.07
|
| Rate for Payer: WINHealth Partners Commercial |
$15.60
|
| Rate for Payer: Wise Provider Network Commercial |
$15.12
|
|
|
CATH IV ANGIO ORANGE 14G 5.25"
|
Facility
|
IP
|
$42.68
|
|
| Hospital Charge Code |
2350009
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$24.73 |
| Max. Negotiated Rate |
$42.68 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$41.83
|
| Rate for Payer: Aetna of WY Medicare |
$27.32
|
| Rate for Payer: Altius Commercial |
$40.97
|
| Rate for Payer: Beech Street Commercial |
$41.83
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$41.40
|
| Rate for Payer: Cash Price |
$29.88
|
| Rate for Payer: ChoiceCare Network Commercial |
$41.40
|
| Rate for Payer: Cigna of WY Commercial |
$41.83
|
| Rate for Payer: Entrust Commercial |
$40.55
|
| Rate for Payer: First Choice Health Commercial |
$40.55
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$40.55
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$26.03
|
| Rate for Payer: HealthUtah PPO |
$42.68
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$41.40
|
| Rate for Payer: Multiplan Medicare/VA |
$24.73
|
| Rate for Payer: One Health Plan of WY PPO |
$41.83
|
| Rate for Payer: PacificSource Commercial |
$38.41
|
| Rate for Payer: PHCS PPO |
$41.83
|
| Rate for Payer: Three Rivers PPO |
$32.01
|
| Rate for Payer: TriWest Veterans Administration |
$26.03
|
| Rate for Payer: United Healthcare Commercial |
$40.76
|
| Rate for Payer: United Healthcare Medicare |
$26.03
|
| Rate for Payer: WINHealth Partners Commercial |
$40.55
|
| Rate for Payer: Wise Provider Network Commercial |
$40.55
|
|
|
CATH IV ANGIO ORANGE 14G 5.25"
|
Facility
|
OP
|
$42.68
|
|
| Hospital Charge Code |
2350009
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$23.11 |
| Max. Negotiated Rate |
$42.68 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$41.83
|
| Rate for Payer: Aetna of WY Medicare |
$28.17
|
| Rate for Payer: Altius Commercial |
$40.97
|
| Rate for Payer: Beech Street Commercial |
$41.83
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$41.40
|
| Rate for Payer: Cash Price |
$29.88
|
| Rate for Payer: ChoiceCare Network Commercial |
$41.40
|
| Rate for Payer: Cigna of WY Commercial |
$41.83
|
| Rate for Payer: Entrust Commercial |
$40.55
|
| Rate for Payer: First Choice Health Commercial |
$40.55
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$40.55
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$24.33
|
| Rate for Payer: HealthUtah PPO |
$42.68
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$41.40
|
| Rate for Payer: Multiplan Medicare/VA |
$23.11
|
| Rate for Payer: One Health Plan of WY PPO |
$41.83
|
| Rate for Payer: PacificSource Commercial |
$38.41
|
| Rate for Payer: PHCS PPO |
$41.83
|
| Rate for Payer: Three Rivers PPO |
$32.01
|
| Rate for Payer: TriWest Veterans Administration |
$24.33
|
| Rate for Payer: United Healthcare Commercial |
$40.76
|
| Rate for Payer: United Healthcare Medicare |
$24.33
|
| Rate for Payer: WINHealth Partners Commercial |
$41.83
|
| Rate for Payer: Wise Provider Network Commercial |
$40.55
|
|
|
CATH IV DIFFUSICS 22G 383591
|
Facility
|
OP
|
$17.57
|
|
| Hospital Charge Code |
2350062
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$9.51 |
| Max. Negotiated Rate |
$17.57 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$17.22
|
| Rate for Payer: Aetna of WY Medicare |
$11.60
|
| Rate for Payer: Altius Commercial |
$16.87
|
| Rate for Payer: Beech Street Commercial |
$17.22
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$17.04
|
| Rate for Payer: Cash Price |
$12.30
|
| Rate for Payer: ChoiceCare Network Commercial |
$17.04
|
| Rate for Payer: Cigna of WY Commercial |
$17.22
|
| Rate for Payer: Entrust Commercial |
$16.69
|
| Rate for Payer: First Choice Health Commercial |
$16.69
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$16.69
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$10.01
|
| Rate for Payer: HealthUtah PPO |
$17.57
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$17.04
|
| Rate for Payer: Multiplan Medicare/VA |
$9.51
|
| Rate for Payer: One Health Plan of WY PPO |
$17.22
|
| Rate for Payer: PacificSource Commercial |
$15.81
|
| Rate for Payer: PHCS PPO |
$17.22
|
| Rate for Payer: Three Rivers PPO |
$13.18
|
| Rate for Payer: TriWest Veterans Administration |
$10.01
|
| Rate for Payer: United Healthcare Commercial |
$16.78
|
| Rate for Payer: United Healthcare Medicare |
$10.01
|
| Rate for Payer: WINHealth Partners Commercial |
$17.22
|
| Rate for Payer: Wise Provider Network Commercial |
$16.69
|
|
|
CATH IV DIFFUSICS 22G 383591
|
Facility
|
IP
|
$17.57
|
|
| Hospital Charge Code |
2350062
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$10.18 |
| Max. Negotiated Rate |
$17.57 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$17.22
|
| Rate for Payer: Aetna of WY Medicare |
$11.24
|
| Rate for Payer: Altius Commercial |
$16.87
|
| Rate for Payer: Beech Street Commercial |
$17.22
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$17.04
|
| Rate for Payer: Cash Price |
$12.30
|
| Rate for Payer: ChoiceCare Network Commercial |
$17.04
|
| Rate for Payer: Cigna of WY Commercial |
$17.22
|
| Rate for Payer: Entrust Commercial |
$16.69
|
| Rate for Payer: First Choice Health Commercial |
$16.69
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$16.69
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$10.72
|
| Rate for Payer: HealthUtah PPO |
$17.57
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$17.04
|
| Rate for Payer: Multiplan Medicare/VA |
$10.18
|
| Rate for Payer: One Health Plan of WY PPO |
$17.22
|
| Rate for Payer: PacificSource Commercial |
$15.81
|
| Rate for Payer: PHCS PPO |
$17.22
|
| Rate for Payer: Three Rivers PPO |
$13.18
|
| Rate for Payer: TriWest Veterans Administration |
$10.72
|
| Rate for Payer: United Healthcare Commercial |
$16.78
|
| Rate for Payer: United Healthcare Medicare |
$10.72
|
| Rate for Payer: WINHealth Partners Commercial |
$16.69
|
| Rate for Payer: Wise Provider Network Commercial |
$16.69
|
|
|
CATH IV DIFFUSICS 24G 383590
|
Facility
|
OP
|
$17.74
|
|
| Hospital Charge Code |
2350063
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$9.61 |
| Max. Negotiated Rate |
$17.74 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$17.39
|
| Rate for Payer: Aetna of WY Medicare |
$11.71
|
| Rate for Payer: Altius Commercial |
$17.03
|
| Rate for Payer: Beech Street Commercial |
$17.39
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$17.21
|
| Rate for Payer: Cash Price |
$12.42
|
| Rate for Payer: ChoiceCare Network Commercial |
$17.21
|
| Rate for Payer: Cigna of WY Commercial |
$17.39
|
| Rate for Payer: Entrust Commercial |
$16.85
|
| Rate for Payer: First Choice Health Commercial |
$16.85
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$16.85
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$10.11
|
| Rate for Payer: HealthUtah PPO |
$17.74
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$17.21
|
| Rate for Payer: Multiplan Medicare/VA |
$9.61
|
| Rate for Payer: One Health Plan of WY PPO |
$17.39
|
| Rate for Payer: PacificSource Commercial |
$15.97
|
| Rate for Payer: PHCS PPO |
$17.39
|
| Rate for Payer: Three Rivers PPO |
$13.30
|
| Rate for Payer: TriWest Veterans Administration |
$10.11
|
| Rate for Payer: United Healthcare Commercial |
$16.94
|
| Rate for Payer: United Healthcare Medicare |
$10.11
|
| Rate for Payer: WINHealth Partners Commercial |
$17.39
|
| Rate for Payer: Wise Provider Network Commercial |
$16.85
|
|
|
CATH IV DIFFUSICS 24G 383590
|
Facility
|
IP
|
$17.74
|
|
| Hospital Charge Code |
2350063
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$10.28 |
| Max. Negotiated Rate |
$17.74 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$17.39
|
| Rate for Payer: Aetna of WY Medicare |
$11.35
|
| Rate for Payer: Altius Commercial |
$17.03
|
| Rate for Payer: Beech Street Commercial |
$17.39
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$17.21
|
| Rate for Payer: Cash Price |
$12.42
|
| Rate for Payer: ChoiceCare Network Commercial |
$17.21
|
| Rate for Payer: Cigna of WY Commercial |
$17.39
|
| Rate for Payer: Entrust Commercial |
$16.85
|
| Rate for Payer: First Choice Health Commercial |
$16.85
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$16.85
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$10.82
|
| Rate for Payer: HealthUtah PPO |
$17.74
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$17.21
|
| Rate for Payer: Multiplan Medicare/VA |
$10.28
|
| Rate for Payer: One Health Plan of WY PPO |
$17.39
|
| Rate for Payer: PacificSource Commercial |
$15.97
|
| Rate for Payer: PHCS PPO |
$17.39
|
| Rate for Payer: Three Rivers PPO |
$13.30
|
| Rate for Payer: TriWest Veterans Administration |
$10.82
|
| Rate for Payer: United Healthcare Commercial |
$16.94
|
| Rate for Payer: United Healthcare Medicare |
$10.82
|
| Rate for Payer: WINHealth Partners Commercial |
$16.85
|
| Rate for Payer: Wise Provider Network Commercial |
$16.85
|
|
|
CATHJ UMBILICAL VEIN DX/THER NB
|
Professional
|
Both
|
$238.00
|
|
|
Service Code
|
HCPCS 36510
|
| Min. Negotiated Rate |
$43.11 |
| Max. Negotiated Rate |
$238.00 |
| Rate for Payer: Cash Price |
$166.60
|
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$233.24
|
| Rate for Payer: Aetna of WY Medicare |
$50.72
|
| Rate for Payer: Beech Street Commercial |
$226.10
|
| Rate for Payer: Cash Price |
$166.60
|
| Rate for Payer: ChoiceCare Network Commercial |
$230.86
|
| Rate for Payer: Cigna of WY Commercial |
$233.24
|
| Rate for Payer: First Choice Health Commercial |
$214.20
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$226.10
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$50.72
|
| Rate for Payer: HealthUtah PPO |
$238.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$230.86
|
| Rate for Payer: Multiplan Medicare/VA |
$43.11
|
| Rate for Payer: One Health Plan of WY PPO |
$233.24
|
| Rate for Payer: PacificSource Commercial |
$214.20
|
| Rate for Payer: PHCS PPO |
$226.10
|
| Rate for Payer: Three Rivers PPO |
$178.50
|
| Rate for Payer: TriWest Veterans Administration |
$50.72
|
| Rate for Payer: United Healthcare Commercial |
$226.10
|
| Rate for Payer: WINHealth Partners Commercial |
$202.30
|
|
|
CATH KIT FEMALE
|
Facility
|
IP
|
$4.72
|
|
| Hospital Charge Code |
2750035
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.74 |
| Max. Negotiated Rate |
$4.72 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$4.63
|
| Rate for Payer: Aetna of WY Medicare |
$3.02
|
| Rate for Payer: Altius Commercial |
$4.53
|
| Rate for Payer: Beech Street Commercial |
$4.63
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$4.58
|
| Rate for Payer: Cash Price |
$3.31
|
| Rate for Payer: ChoiceCare Network Commercial |
$4.58
|
| Rate for Payer: Cigna of WY Commercial |
$4.63
|
| Rate for Payer: Entrust Commercial |
$4.48
|
| Rate for Payer: First Choice Health Commercial |
$4.48
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$4.48
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$2.88
|
| Rate for Payer: HealthUtah PPO |
$4.72
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$4.58
|
| Rate for Payer: Multiplan Medicare/VA |
$2.74
|
| Rate for Payer: One Health Plan of WY PPO |
$4.63
|
| Rate for Payer: PacificSource Commercial |
$4.25
|
| Rate for Payer: PHCS PPO |
$4.63
|
| Rate for Payer: Three Rivers PPO |
$3.54
|
| Rate for Payer: TriWest Veterans Administration |
$2.88
|
| Rate for Payer: United Healthcare Commercial |
$4.51
|
| Rate for Payer: United Healthcare Medicare |
$2.88
|
| Rate for Payer: WINHealth Partners Commercial |
$4.48
|
| Rate for Payer: Wise Provider Network Commercial |
$4.48
|
|
|
CATH KIT FEMALE
|
Facility
|
OP
|
$4.72
|
|
| Hospital Charge Code |
2750035
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.56 |
| Max. Negotiated Rate |
$4.72 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$4.63
|
| Rate for Payer: Aetna of WY Medicare |
$3.12
|
| Rate for Payer: Altius Commercial |
$4.53
|
| Rate for Payer: Beech Street Commercial |
$4.63
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$4.58
|
| Rate for Payer: Cash Price |
$3.31
|
| Rate for Payer: ChoiceCare Network Commercial |
$4.58
|
| Rate for Payer: Cigna of WY Commercial |
$4.63
|
| Rate for Payer: Entrust Commercial |
$4.48
|
| Rate for Payer: First Choice Health Commercial |
$4.48
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$4.48
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$2.69
|
| Rate for Payer: HealthUtah PPO |
$4.72
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$4.58
|
| Rate for Payer: Multiplan Medicare/VA |
$2.56
|
| Rate for Payer: One Health Plan of WY PPO |
$4.63
|
| Rate for Payer: PacificSource Commercial |
$4.25
|
| Rate for Payer: PHCS PPO |
$4.63
|
| Rate for Payer: Three Rivers PPO |
$3.54
|
| Rate for Payer: TriWest Veterans Administration |
$2.69
|
| Rate for Payer: United Healthcare Commercial |
$4.51
|
| Rate for Payer: United Healthcare Medicare |
$2.69
|
| Rate for Payer: WINHealth Partners Commercial |
$4.63
|
| Rate for Payer: Wise Provider Network Commercial |
$4.48
|
|
