Shoppable Services at Layton Hospital

General Disclosure

The list of standard charges displayed represent the pricing information for medical items and services required by the federal Hospital Price Transparency Rule. The pricing information does not necessarily reflect your financial responsibility for your hospital visit, for several reasons, including:

  • The listings reflect prices paid by your insurer for services provided during your hospital visit, which may not reflect your share of the costs for these services under the terms of your health plan.
  • The prices for your insurer are only available if your insurer covers the medical items or services under the terms of your health plan.
  • The actual medical items, including medications, and services that are furnished to you during your visit may vary from what is anticipated.
  • You may receive services or supplies from physicians, practitioners or contractors who are not employed by this hospital; the prices for such services or supplies are not listed here.
  • Your insurer may not be contracted with this hospital for all services. The posted prices will not apply to services for which your insurer has not contracted.

These listings do not guarantee pricing, coverage, benefits, or payments. Your financial liability will be based on the medical items and services billed by the hospital, the terms of your insurance policy, and the status of your benefits (i.e., deductibles, out of pocket maximum, co-insurance, and copays) at the time you receive care. Your eligibility and the amounts covered by your insurance are solely determined by your health insurance provider.

We encourage you to contact a Hospital Cost Estimation Specialist at (855) 442-8601 or INTCostEstimate@R1RCM.com or your insurer to obtain more precise information regarding your potential financial liability.

CDM Bill Item Service Code Service Description Payer Plan Name Inpatient Cash Price Inpatient Min Price Inpatient Max Price Inpatient Negotiated Price Outpatient Cash Price Outpatient Min Price Outpatient Max Price Outpatient Negotiated Price Charge Price
1001000098 1648930 00800 ANESTHESIA EQUIPMENT & SUPPLY PER MINUTE (General) / ANESTHESIA PER MINUTE (GENERAL) Health Utah Health Utah $4.70 $1.65 $5.63 $5.32 $4.70 $1.65 $5.63 $5.32 $6.26
1001000098 1648930 00800 ANESTHESIA EQUIPMENT & SUPPLY PER MINUTE (General) / ANESTHESIA PER MINUTE (GENERAL) Wise Wise Network $4.70 $1.65 $5.63 $5.32 $4.70 $1.65 $5.63 $5.32 $6.26
1001000098 1648930 00800 ANESTHESIA EQUIPMENT & SUPPLY PER MINUTE (General) / ANESTHESIA PER MINUTE (GENERAL) WCF Insurance WCF Insurance $4.70 $1.65 $5.63 $4.38 $4.70 $1.65 $5.63 $4.57 $6.26
1001000098 1648930 00800 ANESTHESIA EQUIPMENT & SUPPLY PER MINUTE (General) / ANESTHESIA PER MINUTE (GENERAL) Utah Cancer Control Program (UCCP) Utah Cancer Control Program (UCCP) $4.70 $1.65 $5.63 $0.00 $4.70 $1.65 $5.63 $0.00 $6.26
1001000098 1648930 00800 ANESTHESIA EQUIPMENT & SUPPLY PER MINUTE (General) / ANESTHESIA PER MINUTE (GENERAL) University of Utah University of Utah Healthy Premier $4.70 $1.65 $5.63 $5.32 $4.70 $1.65 $5.63 $5.32 $6.26
1001000098 1648930 00800 ANESTHESIA EQUIPMENT & SUPPLY PER MINUTE (General) / ANESTHESIA PER MINUTE (GENERAL) University of Utah University of Utah Healthy Preferred - Marketplace $4.70 $1.65 $5.63 $5.32 $4.70 $1.65 $5.63 $5.32 $6.26
1001000098 1648930 00800 ANESTHESIA EQUIPMENT & SUPPLY PER MINUTE (General) / ANESTHESIA PER MINUTE (GENERAL) University of Utah University of Utah Healthy Premier - Marketplace $4.70 $1.65 $5.63 $5.32 $4.70 $1.65 $5.63 $5.32 $6.26
1001000098 1648930 00800 ANESTHESIA EQUIPMENT & SUPPLY PER MINUTE (General) / ANESTHESIA PER MINUTE (GENERAL) University of Utah University of Utah Healthy Preferred $4.70 $1.65 $5.63 $5.32 $4.70 $1.65 $5.63 $5.32 $6.26
1001000098 1648930 00800 ANESTHESIA EQUIPMENT & SUPPLY PER MINUTE (General) / ANESTHESIA PER MINUTE (GENERAL) United Healthcare United Healthcare Choice Plus Network $4.70 $1.65 $5.63 $4.44 $4.70 $1.65 $5.63 $4.44 $6.26
1001000098 1648930 00800 ANESTHESIA EQUIPMENT & SUPPLY PER MINUTE (General) / ANESTHESIA PER MINUTE (GENERAL) United Healthcare United Healthcare Options PPO $4.70 $1.65 $5.63 $5.32 $4.70 $1.65 $5.63 $5.32 $6.26
1001000098 1648930 00800 ANESTHESIA EQUIPMENT & SUPPLY PER MINUTE (General) / ANESTHESIA PER MINUTE (GENERAL) Tanner LLC Tanner LLC $4.70 $1.65 $5.63 $4.51 $4.70 $1.65 $5.63 $4.51 $6.26
1001000098 1648930 00800 ANESTHESIA EQUIPMENT & SUPPLY PER MINUTE (General) / ANESTHESIA PER MINUTE (GENERAL) SpringTide SpringTide $4.70 $1.65 $5.63 $5.20 $4.70 $1.65 $5.63 $5.20 $6.26
1001000098 1648930 00800 ANESTHESIA EQUIPMENT & SUPPLY PER MINUTE (General) / ANESTHESIA PER MINUTE (GENERAL) Sinclair Services Company Sinclair Services Company $4.70 $1.65 $5.63 $5.32 $4.70 $1.65 $5.63 $5.32 $6.26
1001000098 1648930 00800 ANESTHESIA EQUIPMENT & SUPPLY PER MINUTE (General) / ANESTHESIA PER MINUTE (GENERAL) SelectHealth SelectHealth Med Network CHIP $4.70 $1.65 $5.63 $3.35 $4.70 $1.65 $5.63 $3.35 $6.26
1001000098 1648930 00800 ANESTHESIA EQUIPMENT & SUPPLY PER MINUTE (General) / ANESTHESIA PER MINUTE (GENERAL) SelectHealth SelectHealth Care Network $4.70 $1.65 $5.63 $3.52 $4.70 $1.65 $5.63 $3.52 $6.26
1001000098 1648930 00800 ANESTHESIA EQUIPMENT & SUPPLY PER MINUTE (General) / ANESTHESIA PER MINUTE (GENERAL) SelectHealth SelectHealth Med Network Federal Employee (FEHBP) $4.70 $1.65 $5.63 $3.35 $4.70 $1.65 $5.63 $3.35 $6.26
1001000098 1648930 00800 ANESTHESIA EQUIPMENT & SUPPLY PER MINUTE (General) / ANESTHESIA PER MINUTE (GENERAL) SelectHealth SelectHealth Med Network Individual Plan (ACA) $4.70 $1.65 $5.63 $1.87 $4.70 $1.65 $5.63 $1.87 $6.26
1001000098 1648930 00800 ANESTHESIA EQUIPMENT & SUPPLY PER MINUTE (General) / ANESTHESIA PER MINUTE (GENERAL) Global Excel Global Excel $4.70 $1.65 $5.63 $5.32 $4.70 $1.65 $5.63 $5.32 $6.26
1001000098 1648930 00800 ANESTHESIA EQUIPMENT & SUPPLY PER MINUTE (General) / ANESTHESIA PER MINUTE (GENERAL) Franklin County Medical Center Franklin County Medical Center $4.70 $1.65 $5.63 $4.51 $4.70 $1.65 $5.63 $4.51 $6.26
1001000098 1648930 00800 ANESTHESIA EQUIPMENT & SUPPLY PER MINUTE (General) / ANESTHESIA PER MINUTE (GENERAL) Franklin County Franklin County $4.70 $1.65 $5.63 $4.51 $4.70 $1.65 $5.63 $4.51 $6.26
1001000098 1648930 00800 ANESTHESIA EQUIPMENT & SUPPLY PER MINUTE (General) / ANESTHESIA PER MINUTE (GENERAL) EMI Health EMI Health Choice $4.70 $1.65 $5.63 $5.32 $4.70 $1.65 $5.63 $5.32 $6.26
1001000098 1648930 00800 ANESTHESIA EQUIPMENT & SUPPLY PER MINUTE (General) / ANESTHESIA PER MINUTE (GENERAL) EMI Health EMI Health Network Care $4.70 $1.65 $5.63 $4.34 $4.70 $1.65 $5.63 $4.34 $6.26
1001000098 1648930 00800 ANESTHESIA EQUIPMENT & SUPPLY PER MINUTE (General) / ANESTHESIA PER MINUTE (GENERAL) EMI Health EMI Health $4.70 $1.65 $5.63 $4.19 $4.70 $1.65 $5.63 $4.19 $6.26
1001000098 1648930 00800 ANESTHESIA EQUIPMENT & SUPPLY PER MINUTE (General) / ANESTHESIA PER MINUTE (GENERAL) Dixie State University Dixie State University $4.70 $1.65 $5.63 $4.51 $4.70 $1.65 $5.63 $4.51 $6.26
1001000098 1648930 00800 ANESTHESIA EQUIPMENT & SUPPLY PER MINUTE (General) / ANESTHESIA PER MINUTE (GENERAL) Deseret Mutual DMBA Deseret Premier $4.70 $1.65 $5.63 $3.89 $4.70 $1.65 $5.63 $3.89 $6.26
1001000098 1648930 00800 ANESTHESIA EQUIPMENT & SUPPLY PER MINUTE (General) / ANESTHESIA PER MINUTE (GENERAL) Deseret Mutual DMBA Deseret Value $4.70 $1.65 $5.63 $3.89 $4.70 $1.65 $5.63 $3.89 $6.26
1001000098 1648930 00800 ANESTHESIA EQUIPMENT & SUPPLY PER MINUTE (General) / ANESTHESIA PER MINUTE (GENERAL) Deseret Mutual DMBA Deseret Select $4.70 $1.65 $5.63 $3.56 $4.70 $1.65 $5.63 $3.56 $6.26
1001000098 1648930 00800 ANESTHESIA EQUIPMENT & SUPPLY PER MINUTE (General) / ANESTHESIA PER MINUTE (GENERAL) Corporation of the President Corporation of the President $4.70 $1.65 $5.63 $4.38 $4.70 $1.65 $5.63 $4.57 $6.26
1001000098 1648930 00800 ANESTHESIA EQUIPMENT & SUPPLY PER MINUTE (General) / ANESTHESIA PER MINUTE (GENERAL) CorVel Corporation CorVel Corporation $4.70 $1.65 $5.63 $4.51 $4.70 $1.65 $5.63 $4.51 $6.26
1001000098 1648930 00800 ANESTHESIA EQUIPMENT & SUPPLY PER MINUTE (General) / ANESTHESIA PER MINUTE (GENERAL) Cigna Healthcare CIGNA PPO and EPO $4.70 $1.65 $5.63 $5.32 $4.70 $1.65 $5.63 $5.32 $6.26
1001000098 1648930 00800 ANESTHESIA EQUIPMENT & SUPPLY PER MINUTE (General) / ANESTHESIA PER MINUTE (GENERAL) Cigna Healthcare CIGNA Managed Care (HMO or Open Access Plus aka OAP) $4.70 $1.65 $5.63 $5.32 $4.70 $1.65 $5.63 $5.32 $6.26
1001000098 1648930 00800 ANESTHESIA EQUIPMENT & SUPPLY PER MINUTE (General) / ANESTHESIA PER MINUTE (GENERAL) Cigna Healthcare CIGNA Utah Connect $4.70 $1.65 $5.63 $5.32 $4.70 $1.65 $5.63 $5.32 $6.26
1001000098 1648930 00800 ANESTHESIA EQUIPMENT & SUPPLY PER MINUTE (General) / ANESTHESIA PER MINUTE (GENERAL) Campbell Scientific Campbell Scientific $4.70 $1.65 $5.63 $4.51 $4.70 $1.65 $5.63 $4.51 $6.26
1001000098 1648930 00800 ANESTHESIA EQUIPMENT & SUPPLY PER MINUTE (General) / ANESTHESIA PER MINUTE (GENERAL) CCCM CCCM $4.70 $1.65 $5.63 $5.57 $4.70 $1.65 $5.63 $5.57 $6.26
1001000098 1648930 00800 ANESTHESIA EQUIPMENT & SUPPLY PER MINUTE (General) / ANESTHESIA PER MINUTE (GENERAL) Big-D Construction Big-D Construction $4.70 $1.65 $5.63 $4.51 $4.70 $1.65 $5.63 $4.51 $6.26
1001000098 1648930 00800 ANESTHESIA EQUIPMENT & SUPPLY PER MINUTE (General) / ANESTHESIA PER MINUTE (GENERAL) BYU Risk Management BYU Risk Management $4.70 $1.65 $5.63 $4.38 $4.70 $1.65 $5.63 $4.57 $6.26
1001000098 1648930 00800 ANESTHESIA EQUIPMENT & SUPPLY PER MINUTE (General) / ANESTHESIA PER MINUTE (GENERAL) BCBS OOS -TRAD BCBS Association-Blue Card Traditional Plan $4.70 $1.65 $5.63 $5.20 $4.70 $1.65 $5.63 $5.20 $6.26
1001000098 1648930 00800 ANESTHESIA EQUIPMENT & SUPPLY PER MINUTE (General) / ANESTHESIA PER MINUTE (GENERAL) BCBS OOS - PPO BCBS Association-Blue Card PPO Plan $4.70 $1.65 $5.63 $4.38 $4.70 $1.65 $5.63 $4.38 $6.26
1001000098 1648930 00800 ANESTHESIA EQUIPMENT & SUPPLY PER MINUTE (General) / ANESTHESIA PER MINUTE (GENERAL) Altius Altius (Coventry) Limited Facility $4.70 $1.65 $5.63 $5.32 $4.70 $1.65 $5.63 $5.32 $6.26
1001000098 1648930 00800 ANESTHESIA EQUIPMENT & SUPPLY PER MINUTE (General) / ANESTHESIA PER MINUTE (GENERAL) Aetna Aetna Utah Connected Network $4.70 $1.65 $5.63 $5.01 $4.70 $1.65 $5.63 $5.07 $6.26
1001000098 1648930 00800 ANESTHESIA EQUIPMENT & SUPPLY PER MINUTE (General) / ANESTHESIA PER MINUTE (GENERAL) Aetna Aetna Standard Network AKA Aetna Health Plan Network for Utah $4.70 $1.65 $5.63 $5.32 $4.70 $1.65 $5.63 $5.32 $6.26
1001000098 1648930 00800 ANESTHESIA EQUIPMENT & SUPPLY PER MINUTE (General) / ANESTHESIA PER MINUTE (GENERAL) 1-800 Contacts 1-800 Contacts $4.70 $1.65 $5.63 $4.51 $4.70 $1.65 $5.63 $4.51 $6.26
1001000098 1648930 00800 ANESTHESIA EQUIPMENT & SUPPLY PER MINUTE (General) / ANESTHESIA PER MINUTE (GENERAL) HealthSCOPE Benefits, Inc. HealthSCOPE Benefits, Inc. $4.70 $1.65 $5.63 $4.88 $4.70 $1.65 $5.63 $4.88 $6.26
1001000098 1648930 00800 ANESTHESIA EQUIPMENT & SUPPLY PER MINUTE (General) / ANESTHESIA PER MINUTE (GENERAL) Humana Humana ChoiceCare $4.70 $1.65 $5.63 $5.32 $4.70 $1.65 $5.63 $5.32 $6.26
1001000098 1648930 00800 ANESTHESIA EQUIPMENT & SUPPLY PER MINUTE (General) / ANESTHESIA PER MINUTE (GENERAL) Hygeia Corporation Hygeia Corporation $4.70 $1.65 $5.63 $5.63 $4.70 $1.65 $5.63 $5.63 $6.26
1001000098 1648930 00800 ANESTHESIA EQUIPMENT & SUPPLY PER MINUTE (General) / ANESTHESIA PER MINUTE (GENERAL) Icon Health Fitness Icon Health Fitness $4.70 $1.65 $5.63 $4.51 $4.70 $1.65 $5.63 $4.51 $6.26
1001000098 1648930 00800 ANESTHESIA EQUIPMENT & SUPPLY PER MINUTE (General) / ANESTHESIA PER MINUTE (GENERAL) Injury Care of Nevada Injury Care of Nevada $4.70 $1.65 $5.63 $4.70 $4.70 $1.65 $5.63 $4.70 $6.26
1001000098 1648930 00800 ANESTHESIA EQUIPMENT & SUPPLY PER MINUTE (General) / ANESTHESIA PER MINUTE (GENERAL) Inovar Inovar $4.70 $1.65 $5.63 $4.51 $4.70 $1.65 $5.63 $4.51 $6.26
1001000098 1648930 00800 ANESTHESIA EQUIPMENT & SUPPLY PER MINUTE (General) / ANESTHESIA PER MINUTE (GENERAL) Juniper Systems Juniper Systems $4.70 $1.65 $5.63 $4.51 $4.70 $1.65 $5.63 $4.51 $6.26
1001000098 1648930 00800 ANESTHESIA EQUIPMENT & SUPPLY PER MINUTE (General) / ANESTHESIA PER MINUTE (GENERAL) LW Miller LW Miller $4.70 $1.65 $5.63 $4.51 $4.70 $1.65 $5.63 $4.51 $6.26
1001000098 1648930 00800 ANESTHESIA EQUIPMENT & SUPPLY PER MINUTE (General) / ANESTHESIA PER MINUTE (GENERAL) Managed Care Administrators, Inc. Managed Care Administrators, Inc. $4.70 $1.65 $5.63 $4.88 $4.70 $1.65 $5.63 $4.88 $6.26
1001000098 1648930 00800 ANESTHESIA EQUIPMENT & SUPPLY PER MINUTE (General) / ANESTHESIA PER MINUTE (GENERAL) Management and Training Corporation (MTC) - for Clearfield Job Corps $4.70 $1.65 $5.63 $5.32 $4.70 $1.65 $5.63 $5.32 $6.26
1001000098 1648930 00800 ANESTHESIA EQUIPMENT & SUPPLY PER MINUTE (General) / ANESTHESIA PER MINUTE (GENERAL) MedCare International, Inc. MedCare International, Inc. $4.70 $1.65 $5.63 $5.32 $4.70 $1.65 $5.63 $5.32 $6.26
1001000098 1648930 00800 ANESTHESIA EQUIPMENT & SUPPLY PER MINUTE (General) / ANESTHESIA PER MINUTE (GENERAL) Molina Healthcare of Utah Molina CHIP $4.70 $1.65 $5.63 $5.16 $4.70 $1.65 $5.63 $5.16 $6.26
1001000098 1648930 00800 ANESTHESIA EQUIPMENT & SUPPLY PER MINUTE (General) / ANESTHESIA PER MINUTE (GENERAL) Molina Healthcare of Utah Molina Marketplace $4.70 $1.65 $5.63 $5.16 $4.70 $1.65 $5.63 $5.16 $6.26
1001000098 1648930 00800 ANESTHESIA EQUIPMENT & SUPPLY PER MINUTE (General) / ANESTHESIA PER MINUTE (GENERAL) MotivHealth MotivHealth $4.70 $1.65 $5.63 $5.32 $4.70 $1.65 $5.63 $5.32 $6.26
1001000098 1648930 00800 ANESTHESIA EQUIPMENT & SUPPLY PER MINUTE (General) / ANESTHESIA PER MINUTE (GENERAL) PEHP PEHP Preferred Care $4.70 $1.65 $5.63 $5.57 $4.70 $1.65 $5.63 $5.57 $6.26
1001000098 1648930 00800 ANESTHESIA EQUIPMENT & SUPPLY PER MINUTE (General) / ANESTHESIA PER MINUTE (GENERAL) PEHP PEHP Summit Exclusive $4.70 $1.65 $5.63 $5.32 $4.70 $1.65 $5.63 $5.32 $6.26
1001000098 1648930 00800 ANESTHESIA EQUIPMENT & SUPPLY PER MINUTE (General) / ANESTHESIA PER MINUTE (GENERAL) PEHP PEHP Advantage Care State Employees and Advantage Care Exclusive $4.70 $1.65 $5.63 $4.38 $4.70 $1.65 $5.63 $4.38 $6.26
1001000098 1648930 00800 ANESTHESIA EQUIPMENT & SUPPLY PER MINUTE (General) / ANESTHESIA PER MINUTE (GENERAL) PEHP PEHP Advantage Care - Non State $4.70 $1.65 $5.63 $4.48 $4.70 $1.65 $5.63 $4.48 $6.26
1001000098 1648930 00800 ANESTHESIA EQUIPMENT & SUPPLY PER MINUTE (General) / ANESTHESIA PER MINUTE (GENERAL) PEHP PEHP Summit Care $4.70 $1.65 $5.63 $5.32 $4.70 $1.65 $5.63 $5.32 $6.26
1001000098 1648930 00800 ANESTHESIA EQUIPMENT & SUPPLY PER MINUTE (General) / ANESTHESIA PER MINUTE (GENERAL) PEHP PEHP Capital Care $4.70 $1.65 $5.63 $5.32 $4.70 $1.65 $5.63 $5.32 $6.26
1001000098 1648930 00800 ANESTHESIA EQUIPMENT & SUPPLY PER MINUTE (General) / ANESTHESIA PER MINUTE (GENERAL) Petersen, Inc. Petersen, Inc. $4.70 $1.65 $5.63 $4.51 $4.70 $1.65 $5.63 $4.51 $6.26
1001000098 1648930 00800 ANESTHESIA EQUIPMENT & SUPPLY PER MINUTE (General) / ANESTHESIA PER MINUTE (GENERAL) Prodegi Corporate Benefit Services, LLC Prodegi Corporate Benefit Services, LLC $4.70 $1.65 $5.63 $5.13 $4.70 $1.65 $5.63 $5.13 $6.26
1001000098 1648930 00800 ANESTHESIA EQUIPMENT & SUPPLY PER MINUTE (General) / ANESTHESIA PER MINUTE (GENERAL) Provider Networks of America Provider Networks of America (PNOA) $4.70 $1.65 $5.63 $4.70 $4.70 $1.65 $5.63 $4.70 $6.26
1001000098 1648930 00800 ANESTHESIA EQUIPMENT & SUPPLY PER MINUTE (General) / ANESTHESIA PER MINUTE (GENERAL) Regence BlueCross BlueShield of Utah Regence Bridgespan RealValue $4.70 $1.65 $5.63 $4.38 $4.70 $1.65 $5.63 $4.38 $6.26
1001000098 1648930 00800 ANESTHESIA EQUIPMENT & SUPPLY PER MINUTE (General) / ANESTHESIA PER MINUTE (GENERAL) Regence BlueCross BlueShield of Utah Regence Focal Point $4.70 $1.65 $5.63 $4.38 $4.70 $1.65 $5.63 $4.38 $6.26
1001000098 1648930 00800 ANESTHESIA EQUIPMENT & SUPPLY PER MINUTE (General) / ANESTHESIA PER MINUTE (GENERAL) Regence BlueCross BlueShield of Utah Regence BCBS ValueCare $4.70 $1.65 $5.63 $4.38 $4.70 $1.65 $5.63 $4.38 $6.26
1001000098 1648930 00800 ANESTHESIA EQUIPMENT & SUPPLY PER MINUTE (General) / ANESTHESIA PER MINUTE (GENERAL) Regence BlueCross BlueShield of Utah Regence BCBS Traditional Plan $4.70 $1.65 $5.63 $5.20 $4.70 $1.65 $5.63 $5.20 $6.26
1001000098 1648930 00800 ANESTHESIA EQUIPMENT & SUPPLY PER MINUTE (General) / ANESTHESIA PER MINUTE (GENERAL) Regence BlueCross BlueShield of Utah Regence BCBS Federal (FEHBP) $4.70 $1.65 $5.63 $4.76 $4.70 $1.65 $5.63 $4.76 $6.26
1001000098 1648930 00800 ANESTHESIA EQUIPMENT & SUPPLY PER MINUTE (General) / ANESTHESIA PER MINUTE (GENERAL) Regence BlueCross BlueShield of Utah Regence BCBS Preferred BlueOption (PBO) $4.70 $1.65 $5.63 $4.82 $4.70 $1.65 $5.63 $4.82 $6.26
1001000098 1648930 00800 ANESTHESIA EQUIPMENT & SUPPLY PER MINUTE (General) / ANESTHESIA PER MINUTE (GENERAL) Regence BlueCross BlueShield of Utah Regence Individual and Family Network $4.70 $1.65 $5.63 $4.38 $4.70 $1.65 $5.63 $4.38 $6.26
1001000098 1648930 00800 ANESTHESIA EQUIPMENT & SUPPLY PER MINUTE (General) / ANESTHESIA PER MINUTE (GENERAL) SelectHealth SelectHealth Share Network $4.70 $1.65 $5.63 $2.95 $4.70 $1.65 $5.63 $2.95 $6.26
1001000098 1648930 00800 ANESTHESIA EQUIPMENT & SUPPLY PER MINUTE (General) / ANESTHESIA PER MINUTE (GENERAL) SelectHealth SelectHealth Med Network $4.70 $1.65 $5.63 $3.35 $4.70 $1.65 $5.63 $3.35 $6.26
1001000098 1648930 00800 ANESTHESIA EQUIPMENT & SUPPLY PER MINUTE (General) / ANESTHESIA PER MINUTE (GENERAL) SelectHealth SelectHealth Value Network Individual Plan (ACA) $4.70 $1.65 $5.63 $1.65 $4.70 $1.65 $5.63 $1.65 $6.26
1001000098 1648930 00800 ANESTHESIA EQUIPMENT & SUPPLY PER MINUTE (General) / ANESTHESIA PER MINUTE (GENERAL) SelectHealth SelectHealth Value Network $4.70 $1.65 $5.63 $2.95 $4.70 $1.65 $5.63 $2.95 $6.26
1901005733 19518969 20560 PT DRY NEEDLING 1 OR 2 MUSC 20560 1-800 Contacts 1-800 Contacts $25.00 $8.80 $30.00 $24.00 $25.00 $8.80 $30.00 $24.00 $33.33
1901005733 19518969 20560 PT DRY NEEDLING 1 OR 2 MUSC 20560 Cigna Healthcare CIGNA PPO and EPO $25.00 $8.80 $30.00 $28.33 $25.00 $8.80 $30.00 $28.33 $33.33
1901005733 19518969 20560 PT DRY NEEDLING 1 OR 2 MUSC 20560 Cigna Healthcare CIGNA Utah Connect $25.00 $8.80 $30.00 $28.33 $25.00 $8.80 $30.00 $28.33 $33.33
1901005733 19518969 20560 PT DRY NEEDLING 1 OR 2 MUSC 20560 Cigna Healthcare CIGNA Managed Care (HMO or Open Access Plus aka OAP) $25.00 $8.80 $30.00 $28.33 $25.00 $8.80 $30.00 $28.33 $33.33
1901005733 19518969 20560 PT DRY NEEDLING 1 OR 2 MUSC 20560 Cigna Healthcare CIGNA Managed Care (HMO or Open Access Plus aka OAP) $25.00 $8.80 $30.00 $28.33 $25.00 $8.80 $30.00 $28.33 $33.33
1901005733 19518969 20560 PT DRY NEEDLING 1 OR 2 MUSC 20560 Campbell Scientific Campbell Scientific $25.00 $8.80 $30.00 $24.00 $25.00 $8.80 $30.00 $24.00 $33.33
1901005733 19518969 20560 PT DRY NEEDLING 1 OR 2 MUSC 20560 Campbell Scientific Campbell Scientific $25.00 $8.80 $30.00 $24.00 $25.00 $8.80 $30.00 $24.00 $33.33
1901005733 19518969 20560 PT DRY NEEDLING 1 OR 2 MUSC 20560 CCCM CCCM $25.00 $8.80 $30.00 $29.66 $25.00 $8.80 $30.00 $29.66 $33.33
1901005733 19518969 20560 PT DRY NEEDLING 1 OR 2 MUSC 20560 CCCM CCCM $25.00 $8.80 $30.00 $29.66 $25.00 $8.80 $30.00 $29.66 $33.33
1901005733 19518969 20560 PT DRY NEEDLING 1 OR 2 MUSC 20560 Big-D Construction Big-D Construction $25.00 $8.80 $30.00 $24.00 $25.00 $8.80 $30.00 $24.00 $33.33
1901005733 19518969 20560 PT DRY NEEDLING 1 OR 2 MUSC 20560 Big-D Construction Big-D Construction $25.00 $8.80 $30.00 $24.00 $25.00 $8.80 $30.00 $24.00 $33.33
1901005733 19518969 20560 PT DRY NEEDLING 1 OR 2 MUSC 20560 BYU Risk Management BYU Risk Management $25.00 $8.80 $30.00 $23.33 $25.00 $8.80 $30.00 $24.33 $33.33
1901005733 19518969 20560 PT DRY NEEDLING 1 OR 2 MUSC 20560 BYU Risk Management BYU Risk Management $25.00 $8.80 $30.00 $23.33 $25.00 $8.80 $30.00 $24.33 $33.33
1901005733 19518969 20560 PT DRY NEEDLING 1 OR 2 MUSC 20560 BCBS OOS -TRAD BCBS Association-Blue Card Traditional Plan $25.00 $8.80 $30.00 $27.66 $25.00 $8.80 $30.00 $27.66 $33.33
1901005733 19518969 20560 PT DRY NEEDLING 1 OR 2 MUSC 20560 BCBS OOS -TRAD BCBS Association-Blue Card Traditional Plan $25.00 $8.80 $30.00 $27.66 $25.00 $8.80 $30.00 $27.66 $33.33
1901005733 19518969 20560 PT DRY NEEDLING 1 OR 2 MUSC 20560 BCBS OOS - PPO BCBS Association-Blue Card PPO Plan $25.00 $8.80 $30.00 $23.33 $25.00 $8.80 $30.00 $23.33 $33.33
1901005733 19518969 20560 PT DRY NEEDLING 1 OR 2 MUSC 20560 BCBS OOS - PPO BCBS Association-Blue Card PPO Plan $25.00 $8.80 $30.00 $23.33 $25.00 $8.80 $30.00 $23.33 $33.33
1901005733 19518969 20560 PT DRY NEEDLING 1 OR 2 MUSC 20560 Altius Altius (Coventry) Limited Facility $25.00 $8.80 $30.00 $28.33 $25.00 $8.80 $30.00 $28.33 $33.33
1901005733 19518969 20560 PT DRY NEEDLING 1 OR 2 MUSC 20560 Altius Altius (Coventry) Limited Facility $25.00 $8.80 $30.00 $28.33 $25.00 $8.80 $30.00 $28.33 $33.33
1901005733 19518969 20560 PT DRY NEEDLING 1 OR 2 MUSC 20560 Aetna Aetna Standard Network AKA Aetna Health Plan Network for Utah $25.00 $8.80 $30.00 $28.33 $25.00 $8.80 $30.00 $28.33 $33.33
1901005733 19518969 20560 PT DRY NEEDLING 1 OR 2 MUSC 20560 Aetna Aetna Standard Network AKA Aetna Health Plan Network for Utah $25.00 $8.80 $30.00 $28.33 $25.00 $8.80 $30.00 $28.33 $33.33
1901005733 19518969 20560 PT DRY NEEDLING 1 OR 2 MUSC 20560 Aetna Aetna Utah Connected Network $25.00 $8.80 $30.00 $26.66 $25.00 $8.80 $30.00 $27.00 $33.33
1901005733 19518969 20560 PT DRY NEEDLING 1 OR 2 MUSC 20560 Aetna Aetna Utah Connected Network $25.00 $8.80 $30.00 $26.66 $25.00 $8.80 $30.00 $27.00 $33.33