|
CAUT GOLDVAC SLIM PENCIL
|
Facility
|
IP
|
$70.07
|
|
| Hospital Charge Code |
2650907
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$40.61 |
| Max. Negotiated Rate |
$70.07 |
| Rate for Payer: United Healthcare Commercial |
$66.92
|
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$68.67
|
| Rate for Payer: Aetna of WY Medicare |
$44.84
|
| 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 |
$42.74
|
| Rate for Payer: HealthUtah PPO |
$70.07
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$67.97
|
| Rate for Payer: Multiplan Medicare/VA |
$40.61
|
| 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 |
$42.74
|
| Rate for Payer: United Healthcare Medicare |
$42.74
|
| Rate for Payer: WINHealth Partners Commercial |
$66.57
|
| Rate for Payer: Wise Provider Network Commercial |
$66.57
|
|
|
CAUT GROUNDING PAD SPLIT CORD
|
Facility
|
IP
|
$7.78
|
|
| Hospital Charge Code |
2650337
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.51 |
| Max. Negotiated Rate |
$7.78 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$7.62
|
| Rate for Payer: Aetna of WY Medicare |
$4.98
|
| Rate for Payer: Altius Commercial |
$7.47
|
| Rate for Payer: Beech Street Commercial |
$7.62
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$7.55
|
| Rate for Payer: Cash Price |
$5.45
|
| Rate for Payer: ChoiceCare Network Commercial |
$7.55
|
| Rate for Payer: Cigna of WY Commercial |
$7.62
|
| Rate for Payer: Entrust Commercial |
$7.39
|
| Rate for Payer: First Choice Health Commercial |
$7.39
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$7.39
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$4.75
|
| Rate for Payer: HealthUtah PPO |
$7.78
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$7.55
|
| Rate for Payer: Multiplan Medicare/VA |
$4.51
|
| Rate for Payer: One Health Plan of WY PPO |
$7.62
|
| Rate for Payer: PacificSource Commercial |
$7.00
|
| Rate for Payer: PHCS PPO |
$7.62
|
| Rate for Payer: Three Rivers PPO |
$5.84
|
| Rate for Payer: TriWest Veterans Administration |
$4.75
|
| Rate for Payer: United Healthcare Commercial |
$7.43
|
| Rate for Payer: United Healthcare Medicare |
$4.75
|
| Rate for Payer: WINHealth Partners Commercial |
$7.39
|
| Rate for Payer: Wise Provider Network Commercial |
$7.39
|
|
|
CAUT GROUNDING PAD SPLIT CORD
|
Facility
|
OP
|
$7.78
|
|
| Hospital Charge Code |
2650337
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.21 |
| Max. Negotiated Rate |
$7.78 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$7.62
|
| Rate for Payer: Aetna of WY Medicare |
$5.13
|
| Rate for Payer: Altius Commercial |
$7.47
|
| Rate for Payer: Beech Street Commercial |
$7.62
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$7.55
|
| Rate for Payer: Cash Price |
$5.45
|
| Rate for Payer: ChoiceCare Network Commercial |
$7.55
|
| Rate for Payer: Cigna of WY Commercial |
$7.62
|
| Rate for Payer: Entrust Commercial |
$7.39
|
| Rate for Payer: First Choice Health Commercial |
$7.39
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$7.39
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$4.43
|
| Rate for Payer: HealthUtah PPO |
$7.78
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$7.55
|
| Rate for Payer: Multiplan Medicare/VA |
$4.21
|
| Rate for Payer: One Health Plan of WY PPO |
$7.62
|
| Rate for Payer: PacificSource Commercial |
$7.00
|
| Rate for Payer: PHCS PPO |
$7.62
|
| Rate for Payer: Three Rivers PPO |
$5.84
|
| Rate for Payer: TriWest Veterans Administration |
$4.43
|
| Rate for Payer: United Healthcare Commercial |
$7.43
|
| Rate for Payer: United Healthcare Medicare |
$4.43
|
| Rate for Payer: WINHealth Partners Commercial |
$7.62
|
| Rate for Payer: Wise Provider Network Commercial |
$7.39
|
|
|
CAUT NEEDLE POINT
|
Facility
|
IP
|
$3.01
|
|
| Hospital Charge Code |
2650079
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1.74 |
| Max. Negotiated Rate |
$3.01 |
| Rate for Payer: United Healthcare Commercial |
$2.87
|
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2.95
|
| Rate for Payer: Aetna of WY Medicare |
$1.93
|
| Rate for Payer: Altius Commercial |
$2.89
|
| Rate for Payer: Beech Street Commercial |
$2.95
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$2.92
|
| Rate for Payer: Cash Price |
$2.11
|
| Rate for Payer: ChoiceCare Network Commercial |
$2.92
|
| Rate for Payer: Cigna of WY Commercial |
$2.95
|
| Rate for Payer: Entrust Commercial |
$2.86
|
| Rate for Payer: First Choice Health Commercial |
$2.86
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2.86
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$1.84
|
| Rate for Payer: HealthUtah PPO |
$3.01
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2.92
|
| Rate for Payer: Multiplan Medicare/VA |
$1.74
|
| Rate for Payer: One Health Plan of WY PPO |
$2.95
|
| Rate for Payer: PacificSource Commercial |
$2.71
|
| Rate for Payer: PHCS PPO |
$2.95
|
| Rate for Payer: Three Rivers PPO |
$2.26
|
| Rate for Payer: TriWest Veterans Administration |
$1.84
|
| Rate for Payer: United Healthcare Medicare |
$1.84
|
| Rate for Payer: WINHealth Partners Commercial |
$2.86
|
| Rate for Payer: Wise Provider Network Commercial |
$2.86
|
|
|
CAUT NEEDLE POINT
|
Facility
|
OP
|
$3.01
|
|
| Hospital Charge Code |
2650079
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1.63 |
| Max. Negotiated Rate |
$3.01 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$2.95
|
| Rate for Payer: Aetna of WY Medicare |
$1.99
|
| Rate for Payer: Altius Commercial |
$2.89
|
| Rate for Payer: Beech Street Commercial |
$2.95
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$2.92
|
| Rate for Payer: Cash Price |
$2.11
|
| Rate for Payer: ChoiceCare Network Commercial |
$2.92
|
| Rate for Payer: Cigna of WY Commercial |
$2.95
|
| Rate for Payer: Entrust Commercial |
$2.86
|
| Rate for Payer: First Choice Health Commercial |
$2.86
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$2.86
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$1.72
|
| Rate for Payer: HealthUtah PPO |
$3.01
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$2.92
|
| Rate for Payer: Multiplan Medicare/VA |
$1.63
|
| Rate for Payer: One Health Plan of WY PPO |
$2.95
|
| Rate for Payer: PacificSource Commercial |
$2.71
|
| Rate for Payer: PHCS PPO |
$2.95
|
| Rate for Payer: Three Rivers PPO |
$2.26
|
| Rate for Payer: TriWest Veterans Administration |
$1.72
|
| Rate for Payer: United Healthcare Commercial |
$2.87
|
| Rate for Payer: United Healthcare Medicare |
$1.72
|
| Rate for Payer: WINHealth Partners Commercial |
$2.95
|
| Rate for Payer: Wise Provider Network Commercial |
$2.86
|
|
|
CAUT PENCIL BUTTON SWITCH
|
Facility
|
IP
|
$8.61
|
|
| Hospital Charge Code |
2650080
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.99 |
| Max. Negotiated Rate |
$8.61 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$8.44
|
| Rate for Payer: Aetna of WY Medicare |
$5.51
|
| Rate for Payer: Altius Commercial |
$8.27
|
| Rate for Payer: Beech Street Commercial |
$8.44
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$8.35
|
| Rate for Payer: Cash Price |
$6.03
|
| Rate for Payer: ChoiceCare Network Commercial |
$8.35
|
| Rate for Payer: Cigna of WY Commercial |
$8.44
|
| Rate for Payer: Entrust Commercial |
$8.18
|
| Rate for Payer: First Choice Health Commercial |
$8.18
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$8.18
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$5.25
|
| Rate for Payer: HealthUtah PPO |
$8.61
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$8.35
|
| Rate for Payer: Multiplan Medicare/VA |
$4.99
|
| Rate for Payer: One Health Plan of WY PPO |
$8.44
|
| Rate for Payer: PacificSource Commercial |
$7.75
|
| Rate for Payer: PHCS PPO |
$8.44
|
| Rate for Payer: Three Rivers PPO |
$6.46
|
| Rate for Payer: TriWest Veterans Administration |
$5.25
|
| Rate for Payer: United Healthcare Commercial |
$8.22
|
| Rate for Payer: United Healthcare Medicare |
$5.25
|
| Rate for Payer: WINHealth Partners Commercial |
$8.18
|
| Rate for Payer: Wise Provider Network Commercial |
$8.18
|
|
|
CAUT PENCIL BUTTON SWITCH
|
Facility
|
OP
|
$8.61
|
|
| Hospital Charge Code |
2650080
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.66 |
| Max. Negotiated Rate |
$8.61 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$8.44
|
| Rate for Payer: Aetna of WY Medicare |
$5.68
|
| Rate for Payer: Altius Commercial |
$8.27
|
| Rate for Payer: Beech Street Commercial |
$8.44
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$8.35
|
| Rate for Payer: Cash Price |
$6.03
|
| Rate for Payer: ChoiceCare Network Commercial |
$8.35
|
| Rate for Payer: Cigna of WY Commercial |
$8.44
|
| Rate for Payer: Entrust Commercial |
$8.18
|
| Rate for Payer: First Choice Health Commercial |
$8.18
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$8.18
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$4.91
|
| Rate for Payer: HealthUtah PPO |
$8.61
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$8.35
|
| Rate for Payer: Multiplan Medicare/VA |
$4.66
|
| Rate for Payer: One Health Plan of WY PPO |
$8.44
|
| Rate for Payer: PacificSource Commercial |
$7.75
|
| Rate for Payer: PHCS PPO |
$8.44
|
| Rate for Payer: Three Rivers PPO |
$6.46
|
| Rate for Payer: TriWest Veterans Administration |
$4.91
|
| Rate for Payer: United Healthcare Commercial |
$8.22
|
| Rate for Payer: United Healthcare Medicare |
$4.91
|
| Rate for Payer: WINHealth Partners Commercial |
$8.44
|
| Rate for Payer: Wise Provider Network Commercial |
$8.18
|
|
|
CAUT PENCIL ROCKER SWITCH BECK
|
Facility
|
OP
|
$16.26
|
|
| Hospital Charge Code |
2650746
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$8.80 |
| Max. Negotiated Rate |
$16.26 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$15.93
|
| Rate for Payer: Aetna of WY Medicare |
$10.73
|
| Rate for Payer: Altius Commercial |
$15.61
|
| Rate for Payer: Beech Street Commercial |
$15.93
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$15.77
|
| Rate for Payer: Cash Price |
$11.38
|
| Rate for Payer: ChoiceCare Network Commercial |
$15.77
|
| Rate for Payer: Cigna of WY Commercial |
$15.93
|
| Rate for Payer: Entrust Commercial |
$15.45
|
| Rate for Payer: First Choice Health Commercial |
$15.45
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$15.45
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$9.27
|
| Rate for Payer: HealthUtah PPO |
$16.26
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$15.77
|
| Rate for Payer: Multiplan Medicare/VA |
$8.80
|
| Rate for Payer: One Health Plan of WY PPO |
$15.93
|
| Rate for Payer: PacificSource Commercial |
$14.63
|
| Rate for Payer: PHCS PPO |
$15.93
|
| Rate for Payer: Three Rivers PPO |
$12.20
|
| Rate for Payer: TriWest Veterans Administration |
$9.27
|
| Rate for Payer: United Healthcare Commercial |
$15.53
|
| Rate for Payer: United Healthcare Medicare |
$9.27
|
| Rate for Payer: WINHealth Partners Commercial |
$15.93
|
| Rate for Payer: Wise Provider Network Commercial |
$15.45
|
|
|
CAUT PENCIL ROCKER SWITCH BECK
|
Facility
|
IP
|
$16.26
|
|
| Hospital Charge Code |
2650746
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$9.42 |
| Max. Negotiated Rate |
$16.26 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$15.93
|
| Rate for Payer: Aetna of WY Medicare |
$10.41
|
| Rate for Payer: Altius Commercial |
$15.61
|
| Rate for Payer: Beech Street Commercial |
$15.93
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$15.77
|
| Rate for Payer: Cash Price |
$11.38
|
| Rate for Payer: ChoiceCare Network Commercial |
$15.77
|
| Rate for Payer: Cigna of WY Commercial |
$15.93
|
| Rate for Payer: Entrust Commercial |
$15.45
|
| Rate for Payer: First Choice Health Commercial |
$15.45
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$15.45
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$9.92
|
| Rate for Payer: HealthUtah PPO |
$16.26
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$15.77
|
| Rate for Payer: Multiplan Medicare/VA |
$9.42
|
| Rate for Payer: One Health Plan of WY PPO |
$15.93
|
| Rate for Payer: PacificSource Commercial |
$14.63
|
| Rate for Payer: PHCS PPO |
$15.93
|
| Rate for Payer: Three Rivers PPO |
$12.20
|
| Rate for Payer: TriWest Veterans Administration |
$9.92
|
| Rate for Payer: United Healthcare Commercial |
$15.53
|
| Rate for Payer: United Healthcare Medicare |
$9.92
|
| Rate for Payer: WINHealth Partners Commercial |
$15.45
|
| Rate for Payer: Wise Provider Network Commercial |
$15.45
|
|
|
CAUT SMOKE EVAC PENCIL 70MM
|
Facility
|
OP
|
$77.00
|
|
| Hospital Charge Code |
2650889
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$41.70 |
| Max. Negotiated Rate |
$77.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$75.46
|
| Rate for Payer: Aetna of WY Medicare |
$50.82
|
| Rate for Payer: Altius Commercial |
$73.92
|
| Rate for Payer: Beech Street Commercial |
$75.46
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$74.69
|
| Rate for Payer: Cash Price |
$53.90
|
| Rate for Payer: ChoiceCare Network Commercial |
$74.69
|
| Rate for Payer: Cigna of WY Commercial |
$75.46
|
| Rate for Payer: Entrust Commercial |
$73.15
|
| Rate for Payer: First Choice Health Commercial |
$73.15
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$73.15
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$43.89
|
| Rate for Payer: HealthUtah PPO |
$77.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$74.69
|
| Rate for Payer: Multiplan Medicare/VA |
$41.70
|
| Rate for Payer: One Health Plan of WY PPO |
$75.46
|
| Rate for Payer: PacificSource Commercial |
$69.30
|
| Rate for Payer: PHCS PPO |
$75.46
|
| Rate for Payer: Three Rivers PPO |
$57.75
|
| Rate for Payer: TriWest Veterans Administration |
$43.89
|
| Rate for Payer: United Healthcare Commercial |
$73.54
|
| Rate for Payer: United Healthcare Medicare |
$43.89
|
| Rate for Payer: WINHealth Partners Commercial |
$75.46
|
| Rate for Payer: Wise Provider Network Commercial |
$73.15
|
|
|
CAUT SMOKE EVAC PENCIL 70MM
|
Facility
|
IP
|
$77.00
|
|
| Hospital Charge Code |
2650889
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$44.62 |
| Max. Negotiated Rate |
$77.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$75.46
|
| Rate for Payer: Aetna of WY Medicare |
$49.28
|
| Rate for Payer: Altius Commercial |
$73.92
|
| Rate for Payer: Beech Street Commercial |
$75.46
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$74.69
|
| Rate for Payer: Cash Price |
$53.90
|
| Rate for Payer: ChoiceCare Network Commercial |
$74.69
|
| Rate for Payer: Cigna of WY Commercial |
$75.46
|
| Rate for Payer: Entrust Commercial |
$73.15
|
| Rate for Payer: First Choice Health Commercial |
$73.15
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$73.15
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$46.97
|
| Rate for Payer: HealthUtah PPO |
$77.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$74.69
|
| Rate for Payer: Multiplan Medicare/VA |
$44.62
|
| Rate for Payer: One Health Plan of WY PPO |
$75.46
|
| Rate for Payer: PacificSource Commercial |
$69.30
|
| Rate for Payer: PHCS PPO |
$75.46
|
| Rate for Payer: Three Rivers PPO |
$57.75
|
| Rate for Payer: TriWest Veterans Administration |
$46.97
|
| Rate for Payer: United Healthcare Commercial |
$73.54
|
| Rate for Payer: United Healthcare Medicare |
$46.97
|
| Rate for Payer: WINHealth Partners Commercial |
$73.15
|
| Rate for Payer: Wise Provider Network Commercial |
$73.15
|
|
|
CAVETTO CAGE LG 4MM
|
Facility
|
IP
|
$3,850.00
|
|
| Hospital Charge Code |
2800319
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,231.08 |
| Max. Negotiated Rate |
$3,850.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3,773.00
|
| Rate for Payer: Aetna of WY Medicare |
$2,464.00
|
| Rate for Payer: Altius Commercial |
$3,696.00
|
| Rate for Payer: Beech Street Commercial |
$3,773.00
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$3,734.50
|
| Rate for Payer: Cash Price |
$2,695.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$3,734.50
|
| Rate for Payer: Cigna of WY Commercial |
$3,773.00
|
| Rate for Payer: Entrust Commercial |
$3,657.50
|
| Rate for Payer: First Choice Health Commercial |
$3,657.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3,657.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$2,348.50
|
| Rate for Payer: HealthUtah PPO |
$3,850.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3,734.50
|
| Rate for Payer: Multiplan Medicare/VA |
$2,231.08
|
| Rate for Payer: One Health Plan of WY PPO |
$3,773.00
|
| Rate for Payer: PacificSource Commercial |
$3,465.00
|
| Rate for Payer: PHCS PPO |
$3,773.00
|
| Rate for Payer: Three Rivers PPO |
$2,887.50
|
| Rate for Payer: TriWest Veterans Administration |
$2,348.50
|
| Rate for Payer: United Healthcare Commercial |
$3,676.75
|
| Rate for Payer: United Healthcare Medicare |
$2,348.50
|
| Rate for Payer: WINHealth Partners Commercial |
$3,657.50
|
| Rate for Payer: Wise Provider Network Commercial |
$3,657.50
|
|
|
CAVETTO CAGE LG 4MM
|
Facility
|
OP
|
$3,850.00
|
|
| Hospital Charge Code |
2800319
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,084.78 |
| Max. Negotiated Rate |
$3,850.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3,773.00
|
| Rate for Payer: Aetna of WY Medicare |
$2,541.00
|
| Rate for Payer: Altius Commercial |
$3,696.00
|
| Rate for Payer: Beech Street Commercial |
$3,773.00
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$3,734.50
|
| Rate for Payer: Cash Price |
$2,695.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$3,734.50
|
| Rate for Payer: Cigna of WY Commercial |
$3,773.00
|
| Rate for Payer: Entrust Commercial |
$3,657.50
|
| Rate for Payer: First Choice Health Commercial |
$3,657.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3,657.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$2,194.50
|
| Rate for Payer: HealthUtah PPO |
$3,850.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3,734.50
|
| Rate for Payer: Multiplan Medicare/VA |
$2,084.78
|
| Rate for Payer: One Health Plan of WY PPO |
$3,773.00
|
| Rate for Payer: PacificSource Commercial |
$3,465.00
|
| Rate for Payer: PHCS PPO |
$3,773.00
|
| Rate for Payer: Three Rivers PPO |
$2,887.50
|
| Rate for Payer: TriWest Veterans Administration |
$2,194.50
|
| Rate for Payer: United Healthcare Commercial |
$3,676.75
|
| Rate for Payer: United Healthcare Medicare |
$2,194.50
|
| Rate for Payer: WINHealth Partners Commercial |
$3,773.00
|
| Rate for Payer: Wise Provider Network Commercial |
$3,657.50
|
|
|
CAVETTO CAGE LG 5MM
|
Facility
|
OP
|
$3,850.00
|
|
| Hospital Charge Code |
2800154
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,084.78 |
| Max. Negotiated Rate |
$3,850.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3,773.00
|
| Rate for Payer: Aetna of WY Medicare |
$2,541.00
|
| Rate for Payer: Altius Commercial |
$3,696.00
|
| Rate for Payer: Beech Street Commercial |
$3,773.00
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$3,734.50
|
| Rate for Payer: Cash Price |
$2,695.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$3,734.50
|
| Rate for Payer: Cigna of WY Commercial |
$3,773.00
|
| Rate for Payer: Entrust Commercial |
$3,657.50
|
| Rate for Payer: First Choice Health Commercial |
$3,657.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3,657.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$2,194.50
|
| Rate for Payer: HealthUtah PPO |
$3,850.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3,734.50
|
| Rate for Payer: Multiplan Medicare/VA |
$2,084.78
|
| Rate for Payer: One Health Plan of WY PPO |
$3,773.00
|
| Rate for Payer: PacificSource Commercial |
$3,465.00
|
| Rate for Payer: PHCS PPO |
$3,773.00
|
| Rate for Payer: Three Rivers PPO |
$2,887.50
|
| Rate for Payer: TriWest Veterans Administration |
$2,194.50
|
| Rate for Payer: United Healthcare Commercial |
$3,676.75
|
| Rate for Payer: United Healthcare Medicare |
$2,194.50
|
| Rate for Payer: WINHealth Partners Commercial |
$3,773.00
|
| Rate for Payer: Wise Provider Network Commercial |
$3,657.50
|
|
|
CAVETTO CAGE LG 5MM
|
Facility
|
IP
|
$3,850.00
|
|
| Hospital Charge Code |
2800154
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,231.08 |
| Max. Negotiated Rate |
$3,850.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3,773.00
|
| Rate for Payer: Aetna of WY Medicare |
$2,464.00
|
| Rate for Payer: Altius Commercial |
$3,696.00
|
| Rate for Payer: Beech Street Commercial |
$3,773.00
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$3,734.50
|
| Rate for Payer: Cash Price |
$2,695.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$3,734.50
|
| Rate for Payer: Cigna of WY Commercial |
$3,773.00
|
| Rate for Payer: Entrust Commercial |
$3,657.50
|
| Rate for Payer: First Choice Health Commercial |
$3,657.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3,657.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$2,348.50
|
| Rate for Payer: HealthUtah PPO |
$3,850.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3,734.50
|
| Rate for Payer: Multiplan Medicare/VA |
$2,231.08
|
| Rate for Payer: One Health Plan of WY PPO |
$3,773.00
|
| Rate for Payer: PacificSource Commercial |
$3,465.00
|
| Rate for Payer: PHCS PPO |
$3,773.00
|
| Rate for Payer: Three Rivers PPO |
$2,887.50
|
| Rate for Payer: TriWest Veterans Administration |
$2,348.50
|
| Rate for Payer: United Healthcare Commercial |
$3,676.75
|
| Rate for Payer: United Healthcare Medicare |
$2,348.50
|
| Rate for Payer: WINHealth Partners Commercial |
$3,657.50
|
| Rate for Payer: Wise Provider Network Commercial |
$3,657.50
|
|
|
CAVETTO CAGE LG 5MM
|
Facility
|
OP
|
$3,850.00
|
|
| Hospital Charge Code |
2800281
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,084.78 |
| Max. Negotiated Rate |
$3,850.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3,773.00
|
| Rate for Payer: Aetna of WY Medicare |
$2,541.00
|
| Rate for Payer: Altius Commercial |
$3,696.00
|
| Rate for Payer: Beech Street Commercial |
$3,773.00
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$3,734.50
|
| Rate for Payer: Cash Price |
$2,695.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$3,734.50
|
| Rate for Payer: Cigna of WY Commercial |
$3,773.00
|
| Rate for Payer: Entrust Commercial |
$3,657.50
|
| Rate for Payer: First Choice Health Commercial |
$3,657.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3,657.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$2,194.50
|
| Rate for Payer: HealthUtah PPO |
$3,850.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3,734.50
|
| Rate for Payer: Multiplan Medicare/VA |
$2,084.78
|
| Rate for Payer: One Health Plan of WY PPO |
$3,773.00
|
| Rate for Payer: PacificSource Commercial |
$3,465.00
|
| Rate for Payer: PHCS PPO |
$3,773.00
|
| Rate for Payer: Three Rivers PPO |
$2,887.50
|
| Rate for Payer: TriWest Veterans Administration |
$2,194.50
|
| Rate for Payer: United Healthcare Commercial |
$3,676.75
|
| Rate for Payer: United Healthcare Medicare |
$2,194.50
|
| Rate for Payer: WINHealth Partners Commercial |
$3,773.00
|
| Rate for Payer: Wise Provider Network Commercial |
$3,657.50
|
|
|
CAVETTO CAGE LG 5MM
|
Facility
|
IP
|
$3,850.00
|
|
| Hospital Charge Code |
2800281
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,231.08 |
| Max. Negotiated Rate |
$3,850.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3,773.00
|
| Rate for Payer: Aetna of WY Medicare |
$2,464.00
|
| Rate for Payer: Altius Commercial |
$3,696.00
|
| Rate for Payer: Beech Street Commercial |
$3,773.00
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$3,734.50
|
| Rate for Payer: Cash Price |
$2,695.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$3,734.50
|
| Rate for Payer: Cigna of WY Commercial |
$3,773.00
|
| Rate for Payer: Entrust Commercial |
$3,657.50
|
| Rate for Payer: First Choice Health Commercial |
$3,657.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3,657.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$2,348.50
|
| Rate for Payer: HealthUtah PPO |
$3,850.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3,734.50
|
| Rate for Payer: Multiplan Medicare/VA |
$2,231.08
|
| Rate for Payer: One Health Plan of WY PPO |
$3,773.00
|
| Rate for Payer: PacificSource Commercial |
$3,465.00
|
| Rate for Payer: PHCS PPO |
$3,773.00
|
| Rate for Payer: Three Rivers PPO |
$2,887.50
|
| Rate for Payer: TriWest Veterans Administration |
$2,348.50
|
| Rate for Payer: United Healthcare Commercial |
$3,676.75
|
| Rate for Payer: United Healthcare Medicare |
$2,348.50
|
| Rate for Payer: WINHealth Partners Commercial |
$3,657.50
|
| Rate for Payer: Wise Provider Network Commercial |
$3,657.50
|
|
|
CAVETTO CAGE LG 6MM
|
Facility
|
OP
|
$3,850.00
|
|
| Hospital Charge Code |
2800126
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,084.78 |
| Max. Negotiated Rate |
$3,850.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3,773.00
|
| Rate for Payer: Aetna of WY Medicare |
$2,541.00
|
| Rate for Payer: Altius Commercial |
$3,696.00
|
| Rate for Payer: Beech Street Commercial |
$3,773.00
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$3,734.50
|
| Rate for Payer: Cash Price |
$2,695.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$3,734.50
|
| Rate for Payer: Cigna of WY Commercial |
$3,773.00
|
| Rate for Payer: Entrust Commercial |
$3,657.50
|
| Rate for Payer: First Choice Health Commercial |
$3,657.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3,657.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$2,194.50
|
| Rate for Payer: HealthUtah PPO |
$3,850.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3,734.50
|
| Rate for Payer: Multiplan Medicare/VA |
$2,084.78
|
| Rate for Payer: One Health Plan of WY PPO |
$3,773.00
|
| Rate for Payer: PacificSource Commercial |
$3,465.00
|
| Rate for Payer: PHCS PPO |
$3,773.00
|
| Rate for Payer: Three Rivers PPO |
$2,887.50
|
| Rate for Payer: TriWest Veterans Administration |
$2,194.50
|
| Rate for Payer: United Healthcare Commercial |
$3,676.75
|
| Rate for Payer: United Healthcare Medicare |
$2,194.50
|
| Rate for Payer: WINHealth Partners Commercial |
$3,773.00
|
| Rate for Payer: Wise Provider Network Commercial |
$3,657.50
|
|
|
CAVETTO CAGE LG 6MM
|
Facility
|
IP
|
$3,850.00
|
|
| Hospital Charge Code |
2800126
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,231.08 |
| Max. Negotiated Rate |
$3,850.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3,773.00
|
| Rate for Payer: Aetna of WY Medicare |
$2,464.00
|
| Rate for Payer: Altius Commercial |
$3,696.00
|
| Rate for Payer: Beech Street Commercial |
$3,773.00
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$3,734.50
|
| Rate for Payer: Cash Price |
$2,695.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$3,734.50
|
| Rate for Payer: Cigna of WY Commercial |
$3,773.00
|
| Rate for Payer: Entrust Commercial |
$3,657.50
|
| Rate for Payer: First Choice Health Commercial |
$3,657.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3,657.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$2,348.50
|
| Rate for Payer: HealthUtah PPO |
$3,850.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3,734.50
|
| Rate for Payer: Multiplan Medicare/VA |
$2,231.08
|
| Rate for Payer: One Health Plan of WY PPO |
$3,773.00
|
| Rate for Payer: PacificSource Commercial |
$3,465.00
|
| Rate for Payer: PHCS PPO |
$3,773.00
|
| Rate for Payer: Three Rivers PPO |
$2,887.50
|
| Rate for Payer: TriWest Veterans Administration |
$2,348.50
|
| Rate for Payer: United Healthcare Commercial |
$3,676.75
|
| Rate for Payer: United Healthcare Medicare |
$2,348.50
|
| Rate for Payer: WINHealth Partners Commercial |
$3,657.50
|
| Rate for Payer: Wise Provider Network Commercial |
$3,657.50
|
|
|
CAVETTO CAGE LG 7MM
|
Facility
|
IP
|
$3,850.00
|
|
| Hospital Charge Code |
2800136
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,231.08 |
| Max. Negotiated Rate |
$3,850.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3,773.00
|
| Rate for Payer: Aetna of WY Medicare |
$2,464.00
|
| Rate for Payer: Altius Commercial |
$3,696.00
|
| Rate for Payer: Beech Street Commercial |
$3,773.00
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$3,734.50
|
| Rate for Payer: Cash Price |
$2,695.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$3,734.50
|
| Rate for Payer: Cigna of WY Commercial |
$3,773.00
|
| Rate for Payer: Entrust Commercial |
$3,657.50
|
| Rate for Payer: First Choice Health Commercial |
$3,657.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3,657.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$2,348.50
|
| Rate for Payer: HealthUtah PPO |
$3,850.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3,734.50
|
| Rate for Payer: Multiplan Medicare/VA |
$2,231.08
|
| Rate for Payer: One Health Plan of WY PPO |
$3,773.00
|
| Rate for Payer: PacificSource Commercial |
$3,465.00
|
| Rate for Payer: PHCS PPO |
$3,773.00
|
| Rate for Payer: Three Rivers PPO |
$2,887.50
|
| Rate for Payer: TriWest Veterans Administration |
$2,348.50
|
| Rate for Payer: United Healthcare Commercial |
$3,676.75
|
| Rate for Payer: United Healthcare Medicare |
$2,348.50
|
| Rate for Payer: WINHealth Partners Commercial |
$3,657.50
|
| Rate for Payer: Wise Provider Network Commercial |
$3,657.50
|
|
|
CAVETTO CAGE LG 7MM
|
Facility
|
OP
|
$3,850.00
|
|
| Hospital Charge Code |
2800136
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,084.78 |
| Max. Negotiated Rate |
$3,850.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3,773.00
|
| Rate for Payer: Aetna of WY Medicare |
$2,541.00
|
| Rate for Payer: Altius Commercial |
$3,696.00
|
| Rate for Payer: Beech Street Commercial |
$3,773.00
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$3,734.50
|
| Rate for Payer: Cash Price |
$2,695.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$3,734.50
|
| Rate for Payer: Cigna of WY Commercial |
$3,773.00
|
| Rate for Payer: Entrust Commercial |
$3,657.50
|
| Rate for Payer: First Choice Health Commercial |
$3,657.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3,657.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$2,194.50
|
| Rate for Payer: HealthUtah PPO |
$3,850.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3,734.50
|
| Rate for Payer: Multiplan Medicare/VA |
$2,084.78
|
| Rate for Payer: One Health Plan of WY PPO |
$3,773.00
|
| Rate for Payer: PacificSource Commercial |
$3,465.00
|
| Rate for Payer: PHCS PPO |
$3,773.00
|
| Rate for Payer: Three Rivers PPO |
$2,887.50
|
| Rate for Payer: TriWest Veterans Administration |
$2,194.50
|
| Rate for Payer: United Healthcare Commercial |
$3,676.75
|
| Rate for Payer: United Healthcare Medicare |
$2,194.50
|
| Rate for Payer: WINHealth Partners Commercial |
$3,773.00
|
| Rate for Payer: Wise Provider Network Commercial |
$3,657.50
|
|
|
CAVETTO CAGE LG 8MM
|
Facility
|
OP
|
$3,850.00
|
|
| Hospital Charge Code |
2800226
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,084.78 |
| Max. Negotiated Rate |
$3,850.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3,773.00
|
| Rate for Payer: Aetna of WY Medicare |
$2,541.00
|
| Rate for Payer: Altius Commercial |
$3,696.00
|
| Rate for Payer: Beech Street Commercial |
$3,773.00
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$3,734.50
|
| Rate for Payer: Cash Price |
$2,695.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$3,734.50
|
| Rate for Payer: Cigna of WY Commercial |
$3,773.00
|
| Rate for Payer: Entrust Commercial |
$3,657.50
|
| Rate for Payer: First Choice Health Commercial |
$3,657.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3,657.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$2,194.50
|
| Rate for Payer: HealthUtah PPO |
$3,850.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3,734.50
|
| Rate for Payer: Multiplan Medicare/VA |
$2,084.78
|
| Rate for Payer: One Health Plan of WY PPO |
$3,773.00
|
| Rate for Payer: PacificSource Commercial |
$3,465.00
|
| Rate for Payer: PHCS PPO |
$3,773.00
|
| Rate for Payer: Three Rivers PPO |
$2,887.50
|
| Rate for Payer: TriWest Veterans Administration |
$2,194.50
|
| Rate for Payer: United Healthcare Commercial |
$3,676.75
|
| Rate for Payer: United Healthcare Medicare |
$2,194.50
|
| Rate for Payer: WINHealth Partners Commercial |
$3,773.00
|
| Rate for Payer: Wise Provider Network Commercial |
$3,657.50
|
|
|
CAVETTO CAGE LG 8MM
|
Facility
|
IP
|
$3,850.00
|
|
| Hospital Charge Code |
2800226
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,231.08 |
| Max. Negotiated Rate |
$3,850.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3,773.00
|
| Rate for Payer: Aetna of WY Medicare |
$2,464.00
|
| Rate for Payer: Altius Commercial |
$3,696.00
|
| Rate for Payer: Beech Street Commercial |
$3,773.00
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$3,734.50
|
| Rate for Payer: Cash Price |
$2,695.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$3,734.50
|
| Rate for Payer: Cigna of WY Commercial |
$3,773.00
|
| Rate for Payer: Entrust Commercial |
$3,657.50
|
| Rate for Payer: First Choice Health Commercial |
$3,657.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3,657.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$2,348.50
|
| Rate for Payer: HealthUtah PPO |
$3,850.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3,734.50
|
| Rate for Payer: Multiplan Medicare/VA |
$2,231.08
|
| Rate for Payer: One Health Plan of WY PPO |
$3,773.00
|
| Rate for Payer: PacificSource Commercial |
$3,465.00
|
| Rate for Payer: PHCS PPO |
$3,773.00
|
| Rate for Payer: Three Rivers PPO |
$2,887.50
|
| Rate for Payer: TriWest Veterans Administration |
$2,348.50
|
| Rate for Payer: United Healthcare Commercial |
$3,676.75
|
| Rate for Payer: United Healthcare Medicare |
$2,348.50
|
| Rate for Payer: WINHealth Partners Commercial |
$3,657.50
|
| Rate for Payer: Wise Provider Network Commercial |
$3,657.50
|
|
|
CAVETTO CAGE LG 8MM
|
Facility
|
IP
|
$3,850.00
|
|
| Hospital Charge Code |
2800296
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,231.08 |
| Max. Negotiated Rate |
$3,850.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3,773.00
|
| Rate for Payer: Aetna of WY Medicare |
$2,464.00
|
| Rate for Payer: Altius Commercial |
$3,696.00
|
| Rate for Payer: Beech Street Commercial |
$3,773.00
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$3,734.50
|
| Rate for Payer: Cash Price |
$2,695.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$3,734.50
|
| Rate for Payer: Cigna of WY Commercial |
$3,773.00
|
| Rate for Payer: Entrust Commercial |
$3,657.50
|
| Rate for Payer: First Choice Health Commercial |
$3,657.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3,657.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$2,348.50
|
| Rate for Payer: HealthUtah PPO |
$3,850.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3,734.50
|
| Rate for Payer: Multiplan Medicare/VA |
$2,231.08
|
| Rate for Payer: One Health Plan of WY PPO |
$3,773.00
|
| Rate for Payer: PacificSource Commercial |
$3,465.00
|
| Rate for Payer: PHCS PPO |
$3,773.00
|
| Rate for Payer: Three Rivers PPO |
$2,887.50
|
| Rate for Payer: TriWest Veterans Administration |
$2,348.50
|
| Rate for Payer: United Healthcare Commercial |
$3,676.75
|
| Rate for Payer: United Healthcare Medicare |
$2,348.50
|
| Rate for Payer: WINHealth Partners Commercial |
$3,657.50
|
| Rate for Payer: Wise Provider Network Commercial |
$3,657.50
|
|
|
CAVETTO CAGE LG 8MM
|
Facility
|
OP
|
$3,850.00
|
|
| Hospital Charge Code |
2800296
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,084.78 |
| Max. Negotiated Rate |
$3,850.00 |
| Rate for Payer: Aetna of WY Commercial/Medical Rental |
$3,773.00
|
| Rate for Payer: Aetna of WY Medicare |
$2,541.00
|
| Rate for Payer: Altius Commercial |
$3,696.00
|
| Rate for Payer: Beech Street Commercial |
$3,773.00
|
| Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial |
$3,734.50
|
| Rate for Payer: Cash Price |
$2,695.00
|
| Rate for Payer: ChoiceCare Network Commercial |
$3,734.50
|
| Rate for Payer: Cigna of WY Commercial |
$3,773.00
|
| Rate for Payer: Entrust Commercial |
$3,657.50
|
| Rate for Payer: First Choice Health Commercial |
$3,657.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Commercial |
$3,657.50
|
| Rate for Payer: Government Employees Health Association (GEHA) Medicare |
$2,194.50
|
| Rate for Payer: HealthUtah PPO |
$3,850.00
|
| Rate for Payer: Idaho Integrated Healthcare Commercial |
$3,734.50
|
| Rate for Payer: Multiplan Medicare/VA |
$2,084.78
|
| Rate for Payer: One Health Plan of WY PPO |
$3,773.00
|
| Rate for Payer: PacificSource Commercial |
$3,465.00
|
| Rate for Payer: PHCS PPO |
$3,773.00
|
| Rate for Payer: Three Rivers PPO |
$2,887.50
|
| Rate for Payer: TriWest Veterans Administration |
$2,194.50
|
| Rate for Payer: United Healthcare Commercial |
$3,676.75
|
| Rate for Payer: United Healthcare Medicare |
$2,194.50
|
| Rate for Payer: WINHealth Partners Commercial |
$3,773.00
|
| Rate for Payer: Wise Provider Network Commercial |
$3,657.50
|
|
