Daily Room Charge - Revenue Code 203

As a long term care provider (LTCH hospital), Western Peaks provides specialty inpatient services with an average length of stay of 26 days. If you are insured, note that some insurance plans pay at an all inclusive rate called DRG, while others pay at a per day rate. Please note your insurance plan before using this tool. Also, please know that the rates provided are only estimates - every patient’s stay is different. Please contact Western Peaks Specialty Hospital with questions about price estimates.

The following payers pay at an all inclusive methodology (DRG) depending on the type of your stay:

• AETNA-COVENTRY-COFINITY Medicare Advantage
• BLUE CROSS OF UTAH Medicare Advantage
• CIGNA Medicare Advantage
• HEALTHCHOICE UTAH Medicare Advantage
• MEDICARE
• MOLINA Commercial
• MOLINA Medicare Advantage
• PACIFIC SOURCE Medicare Advantage
• TRICARE
• VETERAN AFFAIRS VA, CHAMPVA

In contrast, these other payers pay at a per day rate:

• AARP Medicare Advantage
• AETNA-COVENTRY-COFINITY Commercial Plans (HMO, PPO, POS, etc)
• BLUE CROSS OF UTAH HMO
• CIGNA HMO
• DESERET MUTUAL BENEFITS HMO
• PACIFIC SOURCE Commercial
• PRESBYTERIAN HEALTH PLAN All Plans
• U OF U HEALTH UTAH Medicaid
  
• U OF U HEALTHY UTAH Medicare Advantage, Healthy Premier, Healthy Preferred
  
• UUHP Mountain Health CO-Op and Montana Health CO-OP
  

Please verify with Western Peaks about potential costs associated with Dialysis, Pharmacy, Lab, and Supply charges for your insurance coverage.