|
CATH UMBILICAL 5F 8888160341
|
Facility
|
OP
|
$37.06
|
|
| Hospital Charge Code |
2450008
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$20.07 |
| Max. Negotiated Rate |
$37.06 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$36.32
|
| Rate for Payer: Aetna of WY Medicare |
$24.46
|
| Rate for Payer: Altius Commercial |
$35.58
|
| Rate for Payer: Beech Street Commercial |
$36.32
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$35.95
|
| Rate for Payer: Cash Price |
$25.95
|
| Rate for Payer: ChoiceCare Network Commercial |
$35.95
|
| Rate for Payer: Cigna of WY Commercial |
$36.32
|
| Rate for Payer: Entrust Commercial |
$35.21
|
| Rate for Payer: First Choice Health Commercial |
$35.21
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$35.21
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$21.12
|
| Rate for Payer: HealthUtah PPO |
$37.06
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$35.95
|
| Rate for Payer: Multiplan Medicare/VA |
$20.07
|
| Rate for Payer: One Health Plan of WY PPO |
$36.32
|
| Rate for Payer: PacificSource Commercial |
$33.35
|
| Rate for Payer: PHCS PPO |
$36.32
|
| Rate for Payer: Three Rivers PPO |
$27.80
|
| Rate for Payer: TriWest Veterans Administration |
$21.12
|
| Rate for Payer: United Healthcare Commercial |
$35.39
|
| Rate for Payer: United Healthcare Medicare |
$21.12
|
| Rate for Payer: WINHealth Partners Commercial |
$36.32
|
| Rate for Payer: Wise Provider Network Commercial |
$35.21
|
|
|
CATH UMBILICAL 5F 8888160341
|
Facility
|
IP
|
$37.06
|
|
| Hospital Charge Code |
2450008
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$21.48 |
| Max. Negotiated Rate |
$37.06 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$36.32
|
| Rate for Payer: Aetna of WY Medicare |
$23.72
|
| Rate for Payer: Altius Commercial |
$35.58
|
| Rate for Payer: Beech Street Commercial |
$36.32
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$35.95
|
| Rate for Payer: Cash Price |
$25.95
|
| Rate for Payer: ChoiceCare Network Commercial |
$35.95
|
| Rate for Payer: Cigna of WY Commercial |
$36.32
|
| Rate for Payer: Entrust Commercial |
$35.21
|
| Rate for Payer: First Choice Health Commercial |
$35.21
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$35.21
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$22.61
|
| Rate for Payer: HealthUtah PPO |
$37.06
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$35.95
|
| Rate for Payer: Multiplan Medicare/VA |
$21.48
|
| Rate for Payer: One Health Plan of WY PPO |
$36.32
|
| Rate for Payer: PacificSource Commercial |
$33.35
|
| Rate for Payer: PHCS PPO |
$36.32
|
| Rate for Payer: Three Rivers PPO |
$27.80
|
| Rate for Payer: TriWest Veterans Administration |
$22.61
|
| Rate for Payer: United Healthcare Commercial |
$35.39
|
| Rate for Payer: United Healthcare Medicare |
$22.61
|
| Rate for Payer: WINHealth Partners Commercial |
$35.21
|
| Rate for Payer: Wise Provider Network Commercial |
$35.21
|
|
|
CATH URETERAL OPEN TIP 5F 70CM
|
Facility
|
OP
|
$51.09
|
|
| Hospital Charge Code |
2750139
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$27.67 |
| Max. Negotiated Rate |
$51.09 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$50.07
|
| Rate for Payer: Aetna of WY Medicare |
$33.72
|
| Rate for Payer: Altius Commercial |
$49.05
|
| Rate for Payer: Beech Street Commercial |
$50.07
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$49.56
|
| Rate for Payer: Cash Price |
$35.77
|
| Rate for Payer: ChoiceCare Network Commercial |
$49.56
|
| Rate for Payer: Cigna of WY Commercial |
$50.07
|
| Rate for Payer: Entrust Commercial |
$48.54
|
| Rate for Payer: First Choice Health Commercial |
$48.54
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$48.54
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$29.12
|
| Rate for Payer: HealthUtah PPO |
$51.09
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$49.56
|
| Rate for Payer: Multiplan Medicare/VA |
$27.67
|
| Rate for Payer: One Health Plan of WY PPO |
$50.07
|
| Rate for Payer: PacificSource Commercial |
$45.98
|
| Rate for Payer: PHCS PPO |
$50.07
|
| Rate for Payer: Three Rivers PPO |
$38.32
|
| Rate for Payer: TriWest Veterans Administration |
$29.12
|
| Rate for Payer: United Healthcare Commercial |
$48.79
|
| Rate for Payer: United Healthcare Medicare |
$29.12
|
| Rate for Payer: WINHealth Partners Commercial |
$50.07
|
| Rate for Payer: Wise Provider Network Commercial |
$48.54
|
|
|
CATH URETERAL OPEN TIP 5F 70CM
|
Facility
|
IP
|
$51.09
|
|
| Hospital Charge Code |
2750139
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$29.61 |
| Max. Negotiated Rate |
$51.09 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$50.07
|
| Rate for Payer: Aetna of WY Medicare |
$32.70
|
| Rate for Payer: Altius Commercial |
$49.05
|
| Rate for Payer: Beech Street Commercial |
$50.07
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$49.56
|
| Rate for Payer: Cash Price |
$35.77
|
| Rate for Payer: ChoiceCare Network Commercial |
$49.56
|
| Rate for Payer: Cigna of WY Commercial |
$50.07
|
| Rate for Payer: Entrust Commercial |
$48.54
|
| Rate for Payer: First Choice Health Commercial |
$48.54
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$48.54
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$31.16
|
| Rate for Payer: HealthUtah PPO |
$51.09
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$49.56
|
| Rate for Payer: Multiplan Medicare/VA |
$29.61
|
| Rate for Payer: One Health Plan of WY PPO |
$50.07
|
| Rate for Payer: PacificSource Commercial |
$45.98
|
| Rate for Payer: PHCS PPO |
$50.07
|
| Rate for Payer: Three Rivers PPO |
$38.32
|
| Rate for Payer: TriWest Veterans Administration |
$31.16
|
| Rate for Payer: United Healthcare Commercial |
$48.79
|
| Rate for Payer: United Healthcare Medicare |
$31.16
|
| Rate for Payer: WINHealth Partners Commercial |
$48.54
|
| Rate for Payer: Wise Provider Network Commercial |
$48.54
|
|
|
CATH WORD BARTHOLINS CYST
|
Facility
|
OP
|
$202.21
|
|
| Hospital Charge Code |
2450020
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$109.50 |
| Max. Negotiated Rate |
$202.21 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$198.17
|
| Rate for Payer: Aetna of WY Medicare |
$133.46
|
| Rate for Payer: Altius Commercial |
$194.12
|
| Rate for Payer: Beech Street Commercial |
$198.17
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$196.14
|
| Rate for Payer: Cash Price |
$141.55
|
| Rate for Payer: ChoiceCare Network Commercial |
$196.14
|
| Rate for Payer: Cigna of WY Commercial |
$198.17
|
| Rate for Payer: Entrust Commercial |
$192.10
|
| Rate for Payer: First Choice Health Commercial |
$192.10
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$192.10
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$115.26
|
| Rate for Payer: HealthUtah PPO |
$202.21
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$196.14
|
| Rate for Payer: Multiplan Medicare/VA |
$109.50
|
| Rate for Payer: One Health Plan of WY PPO |
$198.17
|
| Rate for Payer: PacificSource Commercial |
$181.99
|
| Rate for Payer: PHCS PPO |
$198.17
|
| Rate for Payer: Three Rivers PPO |
$151.66
|
| Rate for Payer: TriWest Veterans Administration |
$115.26
|
| Rate for Payer: United Healthcare Commercial |
$193.11
|
| Rate for Payer: United Healthcare Medicare |
$115.26
|
| Rate for Payer: WINHealth Partners Commercial |
$198.17
|
| Rate for Payer: Wise Provider Network Commercial |
$192.10
|
|
|
CATH WORD BARTHOLINS CYST
|
Facility
|
IP
|
$202.21
|
|
| Hospital Charge Code |
2450020
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$117.18 |
| Max. Negotiated Rate |
$202.21 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$198.17
|
| Rate for Payer: Aetna of WY Medicare |
$129.41
|
| Rate for Payer: Altius Commercial |
$194.12
|
| Rate for Payer: Beech Street Commercial |
$198.17
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$196.14
|
| Rate for Payer: Cash Price |
$141.55
|
| Rate for Payer: ChoiceCare Network Commercial |
$196.14
|
| Rate for Payer: Cigna of WY Commercial |
$198.17
|
| Rate for Payer: Entrust Commercial |
$192.10
|
| Rate for Payer: First Choice Health Commercial |
$192.10
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$192.10
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$123.35
|
| Rate for Payer: HealthUtah PPO |
$202.21
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$196.14
|
| Rate for Payer: Multiplan Medicare/VA |
$117.18
|
| Rate for Payer: One Health Plan of WY PPO |
$198.17
|
| Rate for Payer: PacificSource Commercial |
$181.99
|
| Rate for Payer: PHCS PPO |
$198.17
|
| Rate for Payer: Three Rivers PPO |
$151.66
|
| Rate for Payer: TriWest Veterans Administration |
$123.35
|
| Rate for Payer: United Healthcare Commercial |
$193.11
|
| Rate for Payer: United Healthcare Medicare |
$123.35
|
| Rate for Payer: WINHealth Partners Commercial |
$192.10
|
| Rate for Payer: Wise Provider Network Commercial |
$192.10
|
|
|
CAUT CLEAN PAD
|
Facility
|
IP
|
$1.47
|
|
| Hospital Charge Code |
2650076
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$0.85 |
| Max. Negotiated Rate |
$1.47 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1.44
|
| Rate for Payer: Aetna of WY Medicare |
$0.94
|
| Rate for Payer: Altius Commercial |
$1.41
|
| Rate for Payer: Beech Street Commercial |
$1.44
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$1.43
|
| Rate for Payer: Cash Price |
$1.03
|
| Rate for Payer: ChoiceCare Network Commercial |
$1.43
|
| Rate for Payer: Cigna of WY Commercial |
$1.44
|
| Rate for Payer: Entrust Commercial |
$1.40
|
| Rate for Payer: First Choice Health Commercial |
$1.40
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1.40
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$0.90
|
| Rate for Payer: HealthUtah PPO |
$1.47
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1.43
|
| Rate for Payer: Multiplan Medicare/VA |
$0.85
|
| Rate for Payer: One Health Plan of WY PPO |
$1.44
|
| Rate for Payer: PacificSource Commercial |
$1.32
|
| Rate for Payer: PHCS PPO |
$1.44
|
| Rate for Payer: Three Rivers PPO |
$1.10
|
| Rate for Payer: TriWest Veterans Administration |
$0.90
|
| Rate for Payer: United Healthcare Commercial |
$1.40
|
| Rate for Payer: United Healthcare Medicare |
$0.90
|
| Rate for Payer: WINHealth Partners Commercial |
$1.40
|
| Rate for Payer: Wise Provider Network Commercial |
$1.40
|
|
|
CAUT CLEAN PAD
|
Facility
|
OP
|
$1.47
|
|
| Hospital Charge Code |
2650076
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$0.80 |
| Max. Negotiated Rate |
$1.47 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1.44
|
| Rate for Payer: Aetna of WY Medicare |
$0.97
|
| Rate for Payer: Altius Commercial |
$1.41
|
| Rate for Payer: Beech Street Commercial |
$1.44
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$1.43
|
| Rate for Payer: Cash Price |
$1.03
|
| Rate for Payer: ChoiceCare Network Commercial |
$1.43
|
| Rate for Payer: Cigna of WY Commercial |
$1.44
|
| Rate for Payer: Entrust Commercial |
$1.40
|
| Rate for Payer: First Choice Health Commercial |
$1.40
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1.40
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$0.84
|
| Rate for Payer: HealthUtah PPO |
$1.47
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1.43
|
| Rate for Payer: Multiplan Medicare/VA |
$0.80
|
| Rate for Payer: One Health Plan of WY PPO |
$1.44
|
| Rate for Payer: PacificSource Commercial |
$1.32
|
| Rate for Payer: PHCS PPO |
$1.44
|
| Rate for Payer: Three Rivers PPO |
$1.10
|
| Rate for Payer: TriWest Veterans Administration |
$0.84
|
| Rate for Payer: United Healthcare Commercial |
$1.40
|
| Rate for Payer: United Healthcare Medicare |
$0.84
|
| Rate for Payer: WINHealth Partners Commercial |
$1.44
|
| Rate for Payer: Wise Provider Network Commercial |
$1.40
|
|
|
CAUT DISP BIPOLAR DUAL PLUG
|
Facility
|
OP
|
$5.30
|
|
| Hospital Charge Code |
2650827
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.87 |
| Max. Negotiated Rate |
$5.30 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$5.19
|
| Rate for Payer: Aetna of WY Medicare |
$3.50
|
| Rate for Payer: Altius Commercial |
$5.09
|
| Rate for Payer: Beech Street Commercial |
$5.19
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$5.14
|
| Rate for Payer: Cash Price |
$3.71
|
| Rate for Payer: ChoiceCare Network Commercial |
$5.14
|
| Rate for Payer: Cigna of WY Commercial |
$5.19
|
| Rate for Payer: Entrust Commercial |
$5.04
|
| Rate for Payer: First Choice Health Commercial |
$5.04
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$5.04
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$3.02
|
| Rate for Payer: HealthUtah PPO |
$5.30
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$5.14
|
| Rate for Payer: Multiplan Medicare/VA |
$2.87
|
| Rate for Payer: One Health Plan of WY PPO |
$5.19
|
| Rate for Payer: PacificSource Commercial |
$4.77
|
| Rate for Payer: PHCS PPO |
$5.19
|
| Rate for Payer: Three Rivers PPO |
$3.98
|
| Rate for Payer: TriWest Veterans Administration |
$3.02
|
| Rate for Payer: United Healthcare Commercial |
$5.06
|
| Rate for Payer: United Healthcare Medicare |
$3.02
|
| Rate for Payer: WINHealth Partners Commercial |
$5.19
|
| Rate for Payer: Wise Provider Network Commercial |
$5.04
|
|
|
CAUT DISP BIPOLAR DUAL PLUG
|
Facility
|
IP
|
$5.30
|
|
| Hospital Charge Code |
2650827
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.07 |
| Max. Negotiated Rate |
$5.30 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$5.19
|
| Rate for Payer: Aetna of WY Medicare |
$3.39
|
| Rate for Payer: Altius Commercial |
$5.09
|
| Rate for Payer: Beech Street Commercial |
$5.19
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$5.14
|
| Rate for Payer: Cash Price |
$3.71
|
| Rate for Payer: ChoiceCare Network Commercial |
$5.14
|
| Rate for Payer: Cigna of WY Commercial |
$5.19
|
| Rate for Payer: Entrust Commercial |
$5.04
|
| Rate for Payer: First Choice Health Commercial |
$5.04
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$5.04
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$3.23
|
| Rate for Payer: HealthUtah PPO |
$5.30
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$5.14
|
| Rate for Payer: Multiplan Medicare/VA |
$3.07
|
| Rate for Payer: One Health Plan of WY PPO |
$5.19
|
| Rate for Payer: PacificSource Commercial |
$4.77
|
| Rate for Payer: PHCS PPO |
$5.19
|
| Rate for Payer: Three Rivers PPO |
$3.98
|
| Rate for Payer: TriWest Veterans Administration |
$3.23
|
| Rate for Payer: United Healthcare Commercial |
$5.06
|
| Rate for Payer: United Healthcare Medicare |
$3.23
|
| Rate for Payer: WINHealth Partners Commercial |
$5.04
|
| Rate for Payer: Wise Provider Network Commercial |
$5.04
|
|
|
CAUTERY 4" EXTENSION E1450-4
|
Facility
|
OP
|
$12.36
|
|
| Hospital Charge Code |
2650805
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.69 |
| Max. Negotiated Rate |
$12.36 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$12.11
|
| Rate for Payer: Aetna of WY Medicare |
$8.16
|
| Rate for Payer: Altius Commercial |
$11.87
|
| Rate for Payer: Beech Street Commercial |
$12.11
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$11.99
|
| Rate for Payer: Cash Price |
$8.65
|
| Rate for Payer: ChoiceCare Network Commercial |
$11.99
|
| Rate for Payer: Cigna of WY Commercial |
$12.11
|
| Rate for Payer: Entrust Commercial |
$11.74
|
| Rate for Payer: First Choice Health Commercial |
$11.74
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$11.74
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$7.05
|
| Rate for Payer: HealthUtah PPO |
$12.36
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$11.99
|
| Rate for Payer: Multiplan Medicare/VA |
$6.69
|
| Rate for Payer: One Health Plan of WY PPO |
$12.11
|
| Rate for Payer: PacificSource Commercial |
$11.12
|
| Rate for Payer: PHCS PPO |
$12.11
|
| Rate for Payer: Three Rivers PPO |
$9.27
|
| Rate for Payer: TriWest Veterans Administration |
$7.05
|
| Rate for Payer: United Healthcare Commercial |
$11.80
|
| Rate for Payer: United Healthcare Medicare |
$7.05
|
| Rate for Payer: WINHealth Partners Commercial |
$12.11
|
| Rate for Payer: Wise Provider Network Commercial |
$11.74
|
|
|
CAUTERY 4" EXTENSION E1450-4
|
Facility
|
IP
|
$12.36
|
|
| Hospital Charge Code |
2650805
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.16 |
| Max. Negotiated Rate |
$12.36 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$12.11
|
| Rate for Payer: Aetna of WY Medicare |
$7.91
|
| Rate for Payer: Altius Commercial |
$11.87
|
| Rate for Payer: Beech Street Commercial |
$12.11
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$11.99
|
| Rate for Payer: Cash Price |
$8.65
|
| Rate for Payer: ChoiceCare Network Commercial |
$11.99
|
| Rate for Payer: Cigna of WY Commercial |
$12.11
|
| Rate for Payer: Entrust Commercial |
$11.74
|
| Rate for Payer: First Choice Health Commercial |
$11.74
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$11.74
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$7.54
|
| Rate for Payer: HealthUtah PPO |
$12.36
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$11.99
|
| Rate for Payer: Multiplan Medicare/VA |
$7.16
|
| Rate for Payer: One Health Plan of WY PPO |
$12.11
|
| Rate for Payer: PacificSource Commercial |
$11.12
|
| Rate for Payer: PHCS PPO |
$12.11
|
| Rate for Payer: Three Rivers PPO |
$9.27
|
| Rate for Payer: TriWest Veterans Administration |
$7.54
|
| Rate for Payer: United Healthcare Commercial |
$11.80
|
| Rate for Payer: United Healthcare Medicare |
$7.54
|
| Rate for Payer: WINHealth Partners Commercial |
$11.74
|
| Rate for Payer: Wise Provider Network Commercial |
$11.74
|
|
|
CAUTERY CERVIX CRYOCAUTERY INITIAL/REPEAT
|
Professional
|
Both
|
$605.00
|
|
|
Service Code
|
HCPCS 57511
|
| Min. Negotiated Rate |
$122.02 |
| Max. Negotiated Rate |
$605.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$592.90
|
| Rate for Payer: Aetna of WY Medicare |
$143.55
|
| Rate for Payer: Beech Street Commercial |
$574.75
|
| Rate for Payer: Cash Price |
$423.50
|
| Rate for Payer: Cash Price |
$423.50
|
| Rate for Payer: ChoiceCare Network Commercial |
$586.85
|
| Rate for Payer: Cigna of WY Commercial |
$592.90
|
| Rate for Payer: First Choice Health Commercial |
$544.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$574.75
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$143.55
|
| Rate for Payer: HealthUtah PPO |
$605.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$586.85
|
| Rate for Payer: Multiplan Medicare/VA |
$122.02
|
| Rate for Payer: One Health Plan of WY PPO |
$592.90
|
| Rate for Payer: PacificSource Commercial |
$544.50
|
| Rate for Payer: PHCS PPO |
$574.75
|
| Rate for Payer: Three Rivers PPO |
$453.75
|
| Rate for Payer: TriWest Veterans Administration |
$143.55
|
| Rate for Payer: United Healthcare Commercial |
$574.75
|
| Rate for Payer: WINHealth Partners Commercial |
$514.25
|
|
|
CAUTERY CERVIX ELECTRO/THERMAL
|
Professional
|
Both
|
$1,716.00
|
|
|
Service Code
|
HCPCS 57510
|
| Min. Negotiated Rate |
$92.58 |
| Max. Negotiated Rate |
$1,716.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$1,681.68
|
| Rate for Payer: Aetna of WY Medicare |
$108.92
|
| Rate for Payer: Beech Street Commercial |
$1,630.20
|
| Rate for Payer: Cash Price |
$1,201.20
|
| Rate for Payer: Cash Price |
$1,201.20
|
| Rate for Payer: ChoiceCare Network Commercial |
$1,664.52
|
| Rate for Payer: Cigna of WY Commercial |
$1,681.68
|
| Rate for Payer: First Choice Health Commercial |
$1,544.40
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$1,630.20
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$108.92
|
| Rate for Payer: HealthUtah PPO |
$1,716.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$1,664.52
|
| Rate for Payer: Multiplan Medicare/VA |
$92.58
|
| Rate for Payer: One Health Plan of WY PPO |
$1,681.68
|
| Rate for Payer: PacificSource Commercial |
$1,544.40
|
| Rate for Payer: PHCS PPO |
$1,630.20
|
| Rate for Payer: Three Rivers PPO |
$1,287.00
|
| Rate for Payer: TriWest Veterans Administration |
$108.92
|
| Rate for Payer: United Healthcare Commercial |
$1,630.20
|
| Rate for Payer: WINHealth Partners Commercial |
$1,458.60
|
|
|
CAUTERY EXTENSION TIP 6IN
|
Facility
|
OP
|
$11.24
|
|
| Hospital Charge Code |
2650078
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.09 |
| Max. Negotiated Rate |
$11.24 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$11.02
|
| Rate for Payer: Aetna of WY Medicare |
$7.42
|
| Rate for Payer: Altius Commercial |
$10.79
|
| Rate for Payer: Beech Street Commercial |
$11.02
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$10.90
|
| Rate for Payer: Cash Price |
$7.87
|
| Rate for Payer: ChoiceCare Network Commercial |
$10.90
|
| Rate for Payer: Cigna of WY Commercial |
$11.02
|
| Rate for Payer: Entrust Commercial |
$10.68
|
| Rate for Payer: First Choice Health Commercial |
$10.68
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$10.68
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$6.41
|
| Rate for Payer: HealthUtah PPO |
$11.24
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$10.90
|
| Rate for Payer: Multiplan Medicare/VA |
$6.09
|
| Rate for Payer: One Health Plan of WY PPO |
$11.02
|
| Rate for Payer: PacificSource Commercial |
$10.12
|
| Rate for Payer: PHCS PPO |
$11.02
|
| Rate for Payer: Three Rivers PPO |
$8.43
|
| Rate for Payer: TriWest Veterans Administration |
$6.41
|
| Rate for Payer: United Healthcare Commercial |
$10.73
|
| Rate for Payer: United Healthcare Medicare |
$6.41
|
| Rate for Payer: WINHealth Partners Commercial |
$11.02
|
| Rate for Payer: Wise Provider Network Commercial |
$10.68
|
|
|
CAUTERY EXTENSION TIP 6IN
|
Facility
|
IP
|
$11.24
|
|
| Hospital Charge Code |
2650078
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.51 |
| Max. Negotiated Rate |
$11.24 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$11.02
|
| Rate for Payer: Aetna of WY Medicare |
$7.19
|
| Rate for Payer: Altius Commercial |
$10.79
|
| Rate for Payer: Beech Street Commercial |
$11.02
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$10.90
|
| Rate for Payer: Cash Price |
$7.87
|
| Rate for Payer: ChoiceCare Network Commercial |
$10.90
|
| Rate for Payer: Cigna of WY Commercial |
$11.02
|
| Rate for Payer: Entrust Commercial |
$10.68
|
| Rate for Payer: First Choice Health Commercial |
$10.68
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$10.68
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$6.86
|
| Rate for Payer: HealthUtah PPO |
$11.24
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$10.90
|
| Rate for Payer: Multiplan Medicare/VA |
$6.51
|
| Rate for Payer: One Health Plan of WY PPO |
$11.02
|
| Rate for Payer: PacificSource Commercial |
$10.12
|
| Rate for Payer: PHCS PPO |
$11.02
|
| Rate for Payer: Three Rivers PPO |
$8.43
|
| Rate for Payer: TriWest Veterans Administration |
$6.86
|
| Rate for Payer: United Healthcare Commercial |
$10.73
|
| Rate for Payer: United Healthcare Medicare |
$6.86
|
| Rate for Payer: WINHealth Partners Commercial |
$10.68
|
| Rate for Payer: Wise Provider Network Commercial |
$10.68
|
|
|
CAUTERY HIGH TEMP PEN AA21
|
Facility
|
OP
|
$20.70
|
|
| Hospital Charge Code |
2400237
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$11.21 |
| Max. Negotiated Rate |
$20.70 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$20.29
|
| Rate for Payer: Aetna of WY Medicare |
$13.66
|
| Rate for Payer: Altius Commercial |
$19.87
|
| Rate for Payer: Beech Street Commercial |
$20.29
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$20.08
|
| Rate for Payer: Cash Price |
$14.49
|
| Rate for Payer: ChoiceCare Network Commercial |
$20.08
|
| Rate for Payer: Cigna of WY Commercial |
$20.29
|
| Rate for Payer: Entrust Commercial |
$19.66
|
| Rate for Payer: First Choice Health Commercial |
$19.66
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$19.66
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$11.80
|
| Rate for Payer: HealthUtah PPO |
$20.70
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$20.08
|
| Rate for Payer: Multiplan Medicare/VA |
$11.21
|
| Rate for Payer: One Health Plan of WY PPO |
$20.29
|
| Rate for Payer: PacificSource Commercial |
$18.63
|
| Rate for Payer: PHCS PPO |
$20.29
|
| Rate for Payer: Three Rivers PPO |
$15.52
|
| Rate for Payer: TriWest Veterans Administration |
$11.80
|
| Rate for Payer: United Healthcare Commercial |
$19.77
|
| Rate for Payer: United Healthcare Medicare |
$11.80
|
| Rate for Payer: WINHealth Partners Commercial |
$20.29
|
| Rate for Payer: Wise Provider Network Commercial |
$19.66
|
|
|
CAUTERY HIGH TEMP PEN AA21
|
Facility
|
IP
|
$20.70
|
|
| Hospital Charge Code |
2400237
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$12.00 |
| Max. Negotiated Rate |
$20.70 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$20.29
|
| Rate for Payer: Aetna of WY Medicare |
$13.25
|
| Rate for Payer: Altius Commercial |
$19.87
|
| Rate for Payer: Beech Street Commercial |
$20.29
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$20.08
|
| Rate for Payer: Cash Price |
$14.49
|
| Rate for Payer: ChoiceCare Network Commercial |
$20.08
|
| Rate for Payer: Cigna of WY Commercial |
$20.29
|
| Rate for Payer: Entrust Commercial |
$19.66
|
| Rate for Payer: First Choice Health Commercial |
$19.66
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$19.66
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$12.63
|
| Rate for Payer: HealthUtah PPO |
$20.70
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$20.08
|
| Rate for Payer: Multiplan Medicare/VA |
$12.00
|
| Rate for Payer: One Health Plan of WY PPO |
$20.29
|
| Rate for Payer: PacificSource Commercial |
$18.63
|
| Rate for Payer: PHCS PPO |
$20.29
|
| Rate for Payer: Three Rivers PPO |
$15.52
|
| Rate for Payer: TriWest Veterans Administration |
$12.63
|
| Rate for Payer: United Healthcare Commercial |
$19.77
|
| Rate for Payer: United Healthcare Medicare |
$12.63
|
| Rate for Payer: WINHealth Partners Commercial |
$19.66
|
| Rate for Payer: Wise Provider Network Commercial |
$19.66
|
|
|
CAUTERY INSULTED BLADE 2.75"
|
Facility
|
OP
|
$11.07
|
|
| Hospital Charge Code |
2650081
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.99 |
| Max. Negotiated Rate |
$11.07 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$10.85
|
| Rate for Payer: Aetna of WY Medicare |
$7.31
|
| Rate for Payer: Altius Commercial |
$10.63
|
| Rate for Payer: Beech Street Commercial |
$10.85
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$10.74
|
| Rate for Payer: Cash Price |
$7.75
|
| Rate for Payer: ChoiceCare Network Commercial |
$10.74
|
| Rate for Payer: Cigna of WY Commercial |
$10.85
|
| Rate for Payer: Entrust Commercial |
$10.52
|
| Rate for Payer: First Choice Health Commercial |
$10.52
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$10.52
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$6.31
|
| Rate for Payer: HealthUtah PPO |
$11.07
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$10.74
|
| Rate for Payer: Multiplan Medicare/VA |
$5.99
|
| Rate for Payer: One Health Plan of WY PPO |
$10.85
|
| Rate for Payer: PacificSource Commercial |
$9.96
|
| Rate for Payer: PHCS PPO |
$10.85
|
| Rate for Payer: Three Rivers PPO |
$8.30
|
| Rate for Payer: TriWest Veterans Administration |
$6.31
|
| Rate for Payer: United Healthcare Commercial |
$10.57
|
| Rate for Payer: United Healthcare Medicare |
$6.31
|
| Rate for Payer: WINHealth Partners Commercial |
$10.85
|
| Rate for Payer: Wise Provider Network Commercial |
$10.52
|
|
|
CAUTERY INSULTED BLADE 2.75"
|
Facility
|
IP
|
$11.07
|
|
| Hospital Charge Code |
2650081
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.42 |
| Max. Negotiated Rate |
$11.07 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$10.85
|
| Rate for Payer: Aetna of WY Medicare |
$7.08
|
| Rate for Payer: Altius Commercial |
$10.63
|
| Rate for Payer: Beech Street Commercial |
$10.85
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$10.74
|
| Rate for Payer: Cash Price |
$7.75
|
| Rate for Payer: ChoiceCare Network Commercial |
$10.74
|
| Rate for Payer: Cigna of WY Commercial |
$10.85
|
| Rate for Payer: Entrust Commercial |
$10.52
|
| Rate for Payer: First Choice Health Commercial |
$10.52
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$10.52
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$6.75
|
| Rate for Payer: HealthUtah PPO |
$11.07
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$10.74
|
| Rate for Payer: Multiplan Medicare/VA |
$6.42
|
| Rate for Payer: One Health Plan of WY PPO |
$10.85
|
| Rate for Payer: PacificSource Commercial |
$9.96
|
| Rate for Payer: PHCS PPO |
$10.85
|
| Rate for Payer: Three Rivers PPO |
$8.30
|
| Rate for Payer: TriWest Veterans Administration |
$6.75
|
| Rate for Payer: United Healthcare Commercial |
$10.57
|
| Rate for Payer: United Healthcare Medicare |
$6.75
|
| Rate for Payer: WINHealth Partners Commercial |
$10.52
|
| Rate for Payer: Wise Provider Network Commercial |
$10.52
|
|
|
CAUTERY INSULTED BLADE 6.0"
|
Facility
|
OP
|
$11.39
|
|
| Hospital Charge Code |
2650083
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.17 |
| Max. Negotiated Rate |
$11.39 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$11.16
|
| Rate for Payer: Aetna of WY Medicare |
$7.52
|
| Rate for Payer: Altius Commercial |
$10.93
|
| Rate for Payer: Beech Street Commercial |
$11.16
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$11.05
|
| Rate for Payer: Cash Price |
$7.97
|
| Rate for Payer: ChoiceCare Network Commercial |
$11.05
|
| Rate for Payer: Cigna of WY Commercial |
$11.16
|
| Rate for Payer: Entrust Commercial |
$10.82
|
| Rate for Payer: First Choice Health Commercial |
$10.82
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$10.82
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$6.49
|
| Rate for Payer: HealthUtah PPO |
$11.39
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$11.05
|
| Rate for Payer: Multiplan Medicare/VA |
$6.17
|
| Rate for Payer: One Health Plan of WY PPO |
$11.16
|
| Rate for Payer: PacificSource Commercial |
$10.25
|
| Rate for Payer: PHCS PPO |
$11.16
|
| Rate for Payer: Three Rivers PPO |
$8.54
|
| Rate for Payer: TriWest Veterans Administration |
$6.49
|
| Rate for Payer: United Healthcare Commercial |
$10.88
|
| Rate for Payer: United Healthcare Medicare |
$6.49
|
| Rate for Payer: WINHealth Partners Commercial |
$11.16
|
| Rate for Payer: Wise Provider Network Commercial |
$10.82
|
|
|
CAUTERY INSULTED BLADE 6.0"
|
Facility
|
IP
|
$11.39
|
|
| Hospital Charge Code |
2650083
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.60 |
| Max. Negotiated Rate |
$11.39 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$11.16
|
| Rate for Payer: Aetna of WY Medicare |
$7.29
|
| Rate for Payer: Altius Commercial |
$10.93
|
| Rate for Payer: Beech Street Commercial |
$11.16
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$11.05
|
| Rate for Payer: Cash Price |
$7.97
|
| Rate for Payer: ChoiceCare Network Commercial |
$11.05
|
| Rate for Payer: Cigna of WY Commercial |
$11.16
|
| Rate for Payer: Entrust Commercial |
$10.82
|
| Rate for Payer: First Choice Health Commercial |
$10.82
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$10.82
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$6.95
|
| Rate for Payer: HealthUtah PPO |
$11.39
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$11.05
|
| Rate for Payer: Multiplan Medicare/VA |
$6.60
|
| Rate for Payer: One Health Plan of WY PPO |
$11.16
|
| Rate for Payer: PacificSource Commercial |
$10.25
|
| Rate for Payer: PHCS PPO |
$11.16
|
| Rate for Payer: Three Rivers PPO |
$8.54
|
| Rate for Payer: TriWest Veterans Administration |
$6.95
|
| Rate for Payer: United Healthcare Commercial |
$10.88
|
| Rate for Payer: United Healthcare Medicare |
$6.95
|
| Rate for Payer: WINHealth Partners Commercial |
$10.82
|
| Rate for Payer: Wise Provider Network Commercial |
$10.82
|
|
|
CAUTERY INSULTED NEEDLE 2.75"
|
Facility
|
OP
|
$11.42
|
|
| Hospital Charge Code |
2650087
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.18 |
| Max. Negotiated Rate |
$11.42 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$11.19
|
| Rate for Payer: Aetna of WY Medicare |
$7.54
|
| Rate for Payer: Altius Commercial |
$10.96
|
| Rate for Payer: Beech Street Commercial |
$11.19
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$11.08
|
| Rate for Payer: Cash Price |
$8.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$11.08
|
| Rate for Payer: Cigna of WY Commercial |
$11.19
|
| Rate for Payer: Entrust Commercial |
$10.85
|
| Rate for Payer: First Choice Health Commercial |
$10.85
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$10.85
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$6.51
|
| Rate for Payer: HealthUtah PPO |
$11.42
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$11.08
|
| Rate for Payer: Multiplan Medicare/VA |
$6.18
|
| Rate for Payer: One Health Plan of WY PPO |
$11.19
|
| Rate for Payer: PacificSource Commercial |
$10.28
|
| Rate for Payer: PHCS PPO |
$11.19
|
| Rate for Payer: Three Rivers PPO |
$8.56
|
| Rate for Payer: TriWest Veterans Administration |
$6.51
|
| Rate for Payer: United Healthcare Commercial |
$10.91
|
| Rate for Payer: United Healthcare Medicare |
$6.51
|
| Rate for Payer: WINHealth Partners Commercial |
$11.19
|
| Rate for Payer: Wise Provider Network Commercial |
$10.85
|
|
|
CAUTERY INSULTED NEEDLE 2.75"
|
Facility
|
IP
|
$11.42
|
|
| Hospital Charge Code |
2650087
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.62 |
| Max. Negotiated Rate |
$11.42 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$11.19
|
| Rate for Payer: Aetna of WY Medicare |
$7.31
|
| Rate for Payer: Altius Commercial |
$10.96
|
| Rate for Payer: Beech Street Commercial |
$11.19
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$11.08
|
| Rate for Payer: Cash Price |
$8.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$11.08
|
| Rate for Payer: Cigna of WY Commercial |
$11.19
|
| Rate for Payer: Entrust Commercial |
$10.85
|
| Rate for Payer: First Choice Health Commercial |
$10.85
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$10.85
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$6.97
|
| Rate for Payer: HealthUtah PPO |
$11.42
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$11.08
|
| Rate for Payer: Multiplan Medicare/VA |
$6.62
|
| Rate for Payer: One Health Plan of WY PPO |
$11.19
|
| Rate for Payer: PacificSource Commercial |
$10.28
|
| Rate for Payer: PHCS PPO |
$11.19
|
| Rate for Payer: Three Rivers PPO |
$8.56
|
| Rate for Payer: TriWest Veterans Administration |
$6.97
|
| Rate for Payer: United Healthcare Commercial |
$10.91
|
| Rate for Payer: United Healthcare Medicare |
$6.97
|
| Rate for Payer: WINHealth Partners Commercial |
$10.85
|
| Rate for Payer: Wise Provider Network Commercial |
$10.85
|
|
|
CAUT GOLDVAC SLIM PENCIL
|
Facility
|
OP
|
$70.07
|
|
| Hospital Charge Code |
2650907
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$37.94 |
| Max. Negotiated Rate |
$70.07 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$68.67
|
| Rate for Payer: Aetna of WY Medicare |
$46.25
|
| Rate for Payer: Altius Commercial |
$67.27
|
| Rate for Payer: Beech Street Commercial |
$68.67
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$67.97
|
| Rate for Payer: Cash Price |
$49.05
|
| Rate for Payer: ChoiceCare Network Commercial |
$67.97
|
| Rate for Payer: Cigna of WY Commercial |
$68.67
|
| Rate for Payer: Entrust Commercial |
$66.57
|
| Rate for Payer: First Choice Health Commercial |
$66.57
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$66.57
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$39.94
|
| Rate for Payer: HealthUtah PPO |
$70.07
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$67.97
|
| Rate for Payer: Multiplan Medicare/VA |
$37.94
|
| Rate for Payer: One Health Plan of WY PPO |
$68.67
|
| Rate for Payer: PacificSource Commercial |
$63.06
|
| Rate for Payer: PHCS PPO |
$68.67
|
| Rate for Payer: Three Rivers PPO |
$52.55
|
| Rate for Payer: TriWest Veterans Administration |
$39.94
|
| Rate for Payer: United Healthcare Commercial |
$66.92
|
| Rate for Payer: United Healthcare Medicare |
$39.94
|
| Rate for Payer: WINHealth Partners Commercial |
$68.67
|
| Rate for Payer: Wise Provider Network Commercial |
$66.57
|
|
