|
LAB LEUKOCYTE FECAL ASSESSMENT
|
Facility
IP
|
$62.00
|
|
|
Service Code
|
CPT 89055
|
| Hospital Charge Code |
20211001
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$43.40 |
| Max. Negotiated Rate |
$62.00 |
| Rate for Payer: BCBS HMK CHIP |
$55.80
|
| Rate for Payer: AETNA Commercial |
$58.90
|
| Rate for Payer: AETNA Medicare |
$55.80
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$58.90
|
| Rate for Payer: BCBS Healthlink |
$55.80
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$55.80
|
| Rate for Payer: BCBS POS |
$58.90
|
| Rate for Payer: BCBS Traditional |
$62.00
|
| Rate for Payer: CASH_PRICE |
$49.60
|
| Rate for Payer: CIGNA Commercial |
$58.90
|
| Rate for Payer: CIGNA Medicare |
$55.80
|
| Rate for Payer: HUMANA Commercial |
$55.80
|
| Rate for Payer: MEDICAID Medicaid |
$57.04
|
| Rate for Payer: MEDICARE Medicare |
$43.40
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$58.90
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$60.14
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$58.90
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$58.90
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$52.70
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$49.60
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$49.60
|
|
|
LAB LEUKOCYTE FECAL ASSESSMENT
|
Facility
OP
|
$62.00
|
|
|
Service Code
|
CPT 89055
|
| Hospital Charge Code |
20211001
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$43.40 |
| Max. Negotiated Rate |
$62.00 |
| Rate for Payer: AETNA Commercial |
$58.90
|
| Rate for Payer: AETNA Medicare |
$55.80
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$58.90
|
| Rate for Payer: BCBS Healthlink |
$55.80
|
| Rate for Payer: BCBS HMK CHIP |
$55.80
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$55.80
|
| Rate for Payer: BCBS POS |
$58.90
|
| Rate for Payer: BCBS Traditional |
$62.00
|
| Rate for Payer: CASH_PRICE |
$49.60
|
| Rate for Payer: CIGNA Commercial |
$58.90
|
| Rate for Payer: CIGNA Medicare |
$55.80
|
| Rate for Payer: HUMANA Commercial |
$55.80
|
| Rate for Payer: MEDICAID Medicaid |
$57.04
|
| Rate for Payer: MEDICARE Medicare |
$43.40
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$58.90
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$60.14
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$58.90
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$58.90
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$52.70
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$49.60
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$49.60
|
|
|
LAB LYME DIS DNA AMP PROBE
|
Facility
OP
|
$116.00
|
|
|
Service Code
|
CPT 87476
|
| Hospital Charge Code |
20211001
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$81.20 |
| Max. Negotiated Rate |
$116.00 |
| Rate for Payer: AETNA Commercial |
$110.20
|
| Rate for Payer: AETNA Medicare |
$104.40
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$110.20
|
| Rate for Payer: BCBS Healthlink |
$104.40
|
| Rate for Payer: BCBS HMK CHIP |
$104.40
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$104.40
|
| Rate for Payer: BCBS POS |
$110.20
|
| Rate for Payer: BCBS Traditional |
$116.00
|
| Rate for Payer: CASH_PRICE |
$92.80
|
| Rate for Payer: CIGNA Commercial |
$110.20
|
| Rate for Payer: CIGNA Medicare |
$104.40
|
| Rate for Payer: HUMANA Commercial |
$104.40
|
| Rate for Payer: MEDICAID Medicaid |
$106.72
|
| Rate for Payer: MEDICARE Medicare |
$81.20
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$110.20
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$112.52
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$110.20
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$110.20
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$98.60
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$92.80
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$92.80
|
|
|
LAB LYME DIS DNA AMP PROBE
|
Facility
IP
|
$116.00
|
|
|
Service Code
|
CPT 87476
|
| Hospital Charge Code |
20211001
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$81.20 |
| Max. Negotiated Rate |
$116.00 |
| Rate for Payer: AETNA Commercial |
$110.20
|
| Rate for Payer: AETNA Medicare |
$104.40
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$110.20
|
| Rate for Payer: BCBS Healthlink |
$104.40
|
| Rate for Payer: BCBS HMK CHIP |
$104.40
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$104.40
|
| Rate for Payer: BCBS POS |
$110.20
|
| Rate for Payer: BCBS Traditional |
$116.00
|
| Rate for Payer: CASH_PRICE |
$92.80
|
| Rate for Payer: CIGNA Commercial |
$110.20
|
| Rate for Payer: CIGNA Medicare |
$104.40
|
| Rate for Payer: HUMANA Commercial |
$104.40
|
| Rate for Payer: MEDICAID Medicaid |
$106.72
|
| Rate for Payer: MEDICARE Medicare |
$81.20
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$110.20
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$112.52
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$110.20
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$110.20
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$98.60
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$92.80
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$92.80
|
|
|
LAB LYME DISEASE ANTIBODY
|
Facility
IP
|
$121.00
|
|
|
Service Code
|
CPT 86617
|
| Hospital Charge Code |
20211001
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$84.70 |
| Max. Negotiated Rate |
$121.00 |
| Rate for Payer: BCBS HMK CHIP |
$108.90
|
| Rate for Payer: AETNA Commercial |
$114.95
|
| Rate for Payer: AETNA Medicare |
$108.90
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$114.95
|
| Rate for Payer: BCBS Healthlink |
$108.90
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$108.90
|
| Rate for Payer: BCBS POS |
$114.95
|
| Rate for Payer: BCBS Traditional |
$121.00
|
| Rate for Payer: CASH_PRICE |
$96.80
|
| Rate for Payer: CIGNA Commercial |
$114.95
|
| Rate for Payer: CIGNA Medicare |
$108.90
|
| Rate for Payer: HUMANA Commercial |
$108.90
|
| Rate for Payer: MEDICAID Medicaid |
$111.32
|
| Rate for Payer: MEDICARE Medicare |
$84.70
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$114.95
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$117.37
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$114.95
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$114.95
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$102.85
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$96.80
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$96.80
|
|
|
LAB LYME DISEASE ANTIBODY
|
Facility
OP
|
$121.00
|
|
|
Service Code
|
CPT 86617
|
| Hospital Charge Code |
20211001
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$84.70 |
| Max. Negotiated Rate |
$121.00 |
| Rate for Payer: AETNA Commercial |
$114.95
|
| Rate for Payer: AETNA Medicare |
$108.90
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$114.95
|
| Rate for Payer: BCBS Healthlink |
$108.90
|
| Rate for Payer: BCBS HMK CHIP |
$108.90
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$108.90
|
| Rate for Payer: BCBS POS |
$114.95
|
| Rate for Payer: BCBS Traditional |
$121.00
|
| Rate for Payer: CASH_PRICE |
$96.80
|
| Rate for Payer: CIGNA Commercial |
$114.95
|
| Rate for Payer: CIGNA Medicare |
$108.90
|
| Rate for Payer: HUMANA Commercial |
$108.90
|
| Rate for Payer: MEDICAID Medicaid |
$111.32
|
| Rate for Payer: MEDICARE Medicare |
$84.70
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$114.95
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$117.37
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$114.95
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$114.95
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$102.85
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$96.80
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$96.80
|
|
|
LAB LYME DISEASE BORRELIA SEROLOGY
|
Facility
IP
|
$172.00
|
|
|
Service Code
|
CPT 86618
|
| Hospital Charge Code |
20211001
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$120.40 |
| Max. Negotiated Rate |
$172.00 |
| Rate for Payer: AETNA Commercial |
$163.40
|
| Rate for Payer: AETNA Medicare |
$154.80
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$163.40
|
| Rate for Payer: BCBS Healthlink |
$154.80
|
| Rate for Payer: BCBS HMK CHIP |
$154.80
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$154.80
|
| Rate for Payer: BCBS POS |
$163.40
|
| Rate for Payer: BCBS Traditional |
$172.00
|
| Rate for Payer: CASH_PRICE |
$137.60
|
| Rate for Payer: CIGNA Commercial |
$163.40
|
| Rate for Payer: CIGNA Medicare |
$154.80
|
| Rate for Payer: HUMANA Commercial |
$154.80
|
| Rate for Payer: MEDICAID Medicaid |
$158.24
|
| Rate for Payer: MEDICARE Medicare |
$120.40
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$163.40
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$166.84
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$163.40
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$163.40
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$146.20
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$137.60
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$137.60
|
|
|
LAB LYME DISEASE BORRELIA SEROLOGY
|
Facility
OP
|
$172.00
|
|
|
Service Code
|
CPT 86618
|
| Hospital Charge Code |
20211001
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$120.40 |
| Max. Negotiated Rate |
$172.00 |
| Rate for Payer: AETNA Commercial |
$163.40
|
| Rate for Payer: AETNA Medicare |
$154.80
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$163.40
|
| Rate for Payer: BCBS Healthlink |
$154.80
|
| Rate for Payer: BCBS HMK CHIP |
$154.80
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$154.80
|
| Rate for Payer: BCBS POS |
$163.40
|
| Rate for Payer: BCBS Traditional |
$172.00
|
| Rate for Payer: CASH_PRICE |
$137.60
|
| Rate for Payer: CIGNA Commercial |
$163.40
|
| Rate for Payer: CIGNA Medicare |
$154.80
|
| Rate for Payer: HUMANA Commercial |
$154.80
|
| Rate for Payer: MEDICAID Medicaid |
$158.24
|
| Rate for Payer: MEDICARE Medicare |
$120.40
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$163.40
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$166.84
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$163.40
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$163.40
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$146.20
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$137.60
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$137.60
|
|
|
LAB MALASSEZIA MIX IGE
|
Facility
IP
|
$36.00
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
20211001
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$25.20 |
| Max. Negotiated Rate |
$36.00 |
| Rate for Payer: BCBS HMK CHIP |
$32.40
|
| Rate for Payer: AETNA Commercial |
$34.20
|
| Rate for Payer: AETNA Medicare |
$32.40
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$34.20
|
| Rate for Payer: BCBS Healthlink |
$32.40
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$32.40
|
| Rate for Payer: BCBS POS |
$34.20
|
| Rate for Payer: BCBS Traditional |
$36.00
|
| Rate for Payer: CASH_PRICE |
$28.80
|
| Rate for Payer: CIGNA Commercial |
$34.20
|
| Rate for Payer: CIGNA Medicare |
$32.40
|
| Rate for Payer: HUMANA Commercial |
$32.40
|
| Rate for Payer: MEDICAID Medicaid |
$33.12
|
| Rate for Payer: MEDICARE Medicare |
$25.20
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$34.20
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$34.92
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$34.20
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$34.20
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$30.60
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$28.80
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$28.80
|
|
|
LAB MALASSEZIA MIX IGE
|
Facility
OP
|
$36.00
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
20211001
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$25.20 |
| Max. Negotiated Rate |
$36.00 |
| Rate for Payer: AETNA Commercial |
$34.20
|
| Rate for Payer: AETNA Medicare |
$32.40
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$34.20
|
| Rate for Payer: BCBS Healthlink |
$32.40
|
| Rate for Payer: BCBS HMK CHIP |
$32.40
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$32.40
|
| Rate for Payer: BCBS POS |
$34.20
|
| Rate for Payer: BCBS Traditional |
$36.00
|
| Rate for Payer: CASH_PRICE |
$28.80
|
| Rate for Payer: CIGNA Commercial |
$34.20
|
| Rate for Payer: CIGNA Medicare |
$32.40
|
| Rate for Payer: HUMANA Commercial |
$32.40
|
| Rate for Payer: MEDICAID Medicaid |
$33.12
|
| Rate for Payer: MEDICARE Medicare |
$25.20
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$34.20
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$34.92
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$34.20
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$34.20
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$30.60
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$28.80
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$28.80
|
|
|
LAB MANGAN SUPEROXIDE DISMUTASE SPEC IGE
|
Facility
IP
|
$36.00
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
20211001
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$25.20 |
| Max. Negotiated Rate |
$36.00 |
| Rate for Payer: AETNA Commercial |
$34.20
|
| Rate for Payer: AETNA Medicare |
$32.40
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$34.20
|
| Rate for Payer: BCBS Healthlink |
$32.40
|
| Rate for Payer: BCBS HMK CHIP |
$32.40
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$32.40
|
| Rate for Payer: BCBS POS |
$34.20
|
| Rate for Payer: BCBS Traditional |
$36.00
|
| Rate for Payer: CASH_PRICE |
$28.80
|
| Rate for Payer: CIGNA Commercial |
$34.20
|
| Rate for Payer: CIGNA Medicare |
$32.40
|
| Rate for Payer: HUMANA Commercial |
$32.40
|
| Rate for Payer: MEDICAID Medicaid |
$33.12
|
| Rate for Payer: MEDICARE Medicare |
$25.20
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$34.20
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$34.92
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$34.20
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$34.20
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$30.60
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$28.80
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$28.80
|
|
|
LAB MANGAN SUPEROXIDE DISMUTASE SPEC IGE
|
Facility
OP
|
$36.00
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
20211001
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$25.20 |
| Max. Negotiated Rate |
$36.00 |
| Rate for Payer: AETNA Commercial |
$34.20
|
| Rate for Payer: AETNA Medicare |
$32.40
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$34.20
|
| Rate for Payer: BCBS Healthlink |
$32.40
|
| Rate for Payer: BCBS HMK CHIP |
$32.40
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$32.40
|
| Rate for Payer: BCBS POS |
$34.20
|
| Rate for Payer: BCBS Traditional |
$36.00
|
| Rate for Payer: CASH_PRICE |
$28.80
|
| Rate for Payer: CIGNA Commercial |
$34.20
|
| Rate for Payer: CIGNA Medicare |
$32.40
|
| Rate for Payer: HUMANA Commercial |
$32.40
|
| Rate for Payer: MEDICAID Medicaid |
$33.12
|
| Rate for Payer: MEDICARE Medicare |
$25.20
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$34.20
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$34.92
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$34.20
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$34.20
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$30.60
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$28.80
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$28.80
|
|
|
LAB MANUAL UA WITH MICRO
|
Facility
IP
|
$26.00
|
|
|
Service Code
|
CPT 81002
|
| Hospital Charge Code |
20211001
|
|
Hospital Revenue Code
|
307
|
| Min. Negotiated Rate |
$18.20 |
| Max. Negotiated Rate |
$26.00 |
| Rate for Payer: BCBS HMK CHIP |
$23.40
|
| Rate for Payer: AETNA Commercial |
$24.70
|
| Rate for Payer: AETNA Medicare |
$23.40
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$24.70
|
| Rate for Payer: BCBS Healthlink |
$23.40
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$23.40
|
| Rate for Payer: BCBS POS |
$24.70
|
| Rate for Payer: BCBS Traditional |
$26.00
|
| Rate for Payer: CASH_PRICE |
$20.80
|
| Rate for Payer: CIGNA Commercial |
$24.70
|
| Rate for Payer: CIGNA Medicare |
$23.40
|
| Rate for Payer: HUMANA Commercial |
$23.40
|
| Rate for Payer: MEDICAID Medicaid |
$23.92
|
| Rate for Payer: MEDICARE Medicare |
$18.20
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$24.70
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$25.22
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$24.70
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$24.70
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$22.10
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$20.80
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$20.80
|
|
|
LAB MANUAL UA WITH MICRO
|
Facility
OP
|
$26.00
|
|
|
Service Code
|
CPT 81002
|
| Hospital Charge Code |
20211001
|
|
Hospital Revenue Code
|
307
|
| Min. Negotiated Rate |
$18.20 |
| Max. Negotiated Rate |
$26.00 |
| Rate for Payer: AETNA Commercial |
$24.70
|
| Rate for Payer: AETNA Medicare |
$23.40
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$24.70
|
| Rate for Payer: BCBS Healthlink |
$23.40
|
| Rate for Payer: BCBS HMK CHIP |
$23.40
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$23.40
|
| Rate for Payer: BCBS POS |
$24.70
|
| Rate for Payer: BCBS Traditional |
$26.00
|
| Rate for Payer: CASH_PRICE |
$20.80
|
| Rate for Payer: CIGNA Commercial |
$24.70
|
| Rate for Payer: CIGNA Medicare |
$23.40
|
| Rate for Payer: HUMANA Commercial |
$23.40
|
| Rate for Payer: MEDICAID Medicaid |
$23.92
|
| Rate for Payer: MEDICARE Medicare |
$18.20
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$24.70
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$25.22
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$24.70
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$24.70
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$22.10
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$20.80
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$20.80
|
|
|
LAB M AVIUM PROBE
|
Facility
IP
|
$80.00
|
|
|
Service Code
|
CPT 87560
|
| Hospital Charge Code |
20211001
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$56.00 |
| Max. Negotiated Rate |
$80.00 |
| Rate for Payer: BCBS HMK CHIP |
$72.00
|
| Rate for Payer: AETNA Commercial |
$76.00
|
| Rate for Payer: AETNA Medicare |
$72.00
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$76.00
|
| Rate for Payer: BCBS Healthlink |
$72.00
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$72.00
|
| Rate for Payer: BCBS POS |
$76.00
|
| Rate for Payer: BCBS Traditional |
$80.00
|
| Rate for Payer: CASH_PRICE |
$64.00
|
| Rate for Payer: CIGNA Commercial |
$76.00
|
| Rate for Payer: CIGNA Medicare |
$72.00
|
| Rate for Payer: HUMANA Commercial |
$72.00
|
| Rate for Payer: MEDICAID Medicaid |
$73.60
|
| Rate for Payer: MEDICARE Medicare |
$56.00
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$76.00
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$77.60
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$76.00
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$76.00
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$68.00
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$64.00
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$64.00
|
|
|
LAB M AVIUM PROBE
|
Facility
OP
|
$80.00
|
|
|
Service Code
|
CPT 87560
|
| Hospital Charge Code |
20211001
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$56.00 |
| Max. Negotiated Rate |
$80.00 |
| Rate for Payer: AETNA Commercial |
$76.00
|
| Rate for Payer: AETNA Medicare |
$72.00
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$76.00
|
| Rate for Payer: BCBS Healthlink |
$72.00
|
| Rate for Payer: BCBS HMK CHIP |
$72.00
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$72.00
|
| Rate for Payer: BCBS POS |
$76.00
|
| Rate for Payer: BCBS Traditional |
$80.00
|
| Rate for Payer: CASH_PRICE |
$64.00
|
| Rate for Payer: CIGNA Commercial |
$76.00
|
| Rate for Payer: CIGNA Medicare |
$72.00
|
| Rate for Payer: HUMANA Commercial |
$72.00
|
| Rate for Payer: MEDICAID Medicaid |
$73.60
|
| Rate for Payer: MEDICARE Medicare |
$56.00
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$76.00
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$77.60
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$76.00
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$76.00
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$68.00
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$64.00
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$64.00
|
|
|
LAB MERCURY
|
Facility
OP
|
$78.00
|
|
|
Service Code
|
CPT 83825
|
| Hospital Charge Code |
20211001
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$54.60 |
| Max. Negotiated Rate |
$78.00 |
| Rate for Payer: AETNA Commercial |
$74.10
|
| Rate for Payer: AETNA Medicare |
$70.20
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$74.10
|
| Rate for Payer: BCBS Healthlink |
$70.20
|
| Rate for Payer: BCBS HMK CHIP |
$70.20
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$70.20
|
| Rate for Payer: BCBS POS |
$74.10
|
| Rate for Payer: BCBS Traditional |
$78.00
|
| Rate for Payer: CASH_PRICE |
$62.40
|
| Rate for Payer: CIGNA Commercial |
$74.10
|
| Rate for Payer: CIGNA Medicare |
$70.20
|
| Rate for Payer: HUMANA Commercial |
$70.20
|
| Rate for Payer: MEDICAID Medicaid |
$71.76
|
| Rate for Payer: MEDICARE Medicare |
$54.60
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$74.10
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$75.66
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$74.10
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$74.10
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$66.30
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$62.40
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$62.40
|
|
|
LAB MERCURY
|
Facility
IP
|
$78.00
|
|
|
Service Code
|
CPT 83825
|
| Hospital Charge Code |
20211001
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$54.60 |
| Max. Negotiated Rate |
$78.00 |
| Rate for Payer: AETNA Commercial |
$74.10
|
| Rate for Payer: AETNA Medicare |
$70.20
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$74.10
|
| Rate for Payer: BCBS Healthlink |
$70.20
|
| Rate for Payer: BCBS HMK CHIP |
$70.20
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$70.20
|
| Rate for Payer: BCBS POS |
$74.10
|
| Rate for Payer: BCBS Traditional |
$78.00
|
| Rate for Payer: CASH_PRICE |
$62.40
|
| Rate for Payer: CIGNA Commercial |
$74.10
|
| Rate for Payer: CIGNA Medicare |
$70.20
|
| Rate for Payer: HUMANA Commercial |
$70.20
|
| Rate for Payer: MEDICAID Medicaid |
$71.76
|
| Rate for Payer: MEDICARE Medicare |
$54.60
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$74.10
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$75.66
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$74.10
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$74.10
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$66.30
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$62.40
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$62.40
|
|
|
LAB MOPATH PROCEDURE LEVEL 2
|
Facility
IP
|
$352.00
|
|
|
Service Code
|
CPT 81401
|
| Hospital Charge Code |
20211001
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$246.40 |
| Max. Negotiated Rate |
$352.00 |
| Rate for Payer: BCBS HMK CHIP |
$316.80
|
| Rate for Payer: AETNA Commercial |
$334.40
|
| Rate for Payer: AETNA Medicare |
$316.80
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$334.40
|
| Rate for Payer: BCBS Healthlink |
$316.80
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$316.80
|
| Rate for Payer: BCBS POS |
$334.40
|
| Rate for Payer: BCBS Traditional |
$352.00
|
| Rate for Payer: CASH_PRICE |
$281.60
|
| Rate for Payer: CIGNA Commercial |
$334.40
|
| Rate for Payer: CIGNA Medicare |
$316.80
|
| Rate for Payer: HUMANA Commercial |
$316.80
|
| Rate for Payer: MEDICAID Medicaid |
$323.84
|
| Rate for Payer: MEDICARE Medicare |
$246.40
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$334.40
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$341.44
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$334.40
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$334.40
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$299.20
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$281.60
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$281.60
|
|
|
LAB MOPATH PROCEDURE LEVEL 2
|
Facility
OP
|
$352.00
|
|
|
Service Code
|
CPT 81401
|
| Hospital Charge Code |
20211001
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$246.40 |
| Max. Negotiated Rate |
$352.00 |
| Rate for Payer: AETNA Commercial |
$334.40
|
| Rate for Payer: AETNA Medicare |
$316.80
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$334.40
|
| Rate for Payer: BCBS Healthlink |
$316.80
|
| Rate for Payer: BCBS HMK CHIP |
$316.80
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$316.80
|
| Rate for Payer: BCBS POS |
$334.40
|
| Rate for Payer: BCBS Traditional |
$352.00
|
| Rate for Payer: CASH_PRICE |
$281.60
|
| Rate for Payer: CIGNA Commercial |
$334.40
|
| Rate for Payer: CIGNA Medicare |
$316.80
|
| Rate for Payer: HUMANA Commercial |
$316.80
|
| Rate for Payer: MEDICAID Medicaid |
$323.84
|
| Rate for Payer: MEDICARE Medicare |
$246.40
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$334.40
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$341.44
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$334.40
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$334.40
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$299.20
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$281.60
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$281.60
|
|
|
LAB M TB PROBE
|
Facility
IP
|
$83.00
|
|
|
Service Code
|
CPT 87555
|
| Hospital Charge Code |
20211001
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$58.10 |
| Max. Negotiated Rate |
$83.00 |
| Rate for Payer: AETNA Commercial |
$78.85
|
| Rate for Payer: AETNA Medicare |
$74.70
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$78.85
|
| Rate for Payer: BCBS Healthlink |
$74.70
|
| Rate for Payer: BCBS HMK CHIP |
$74.70
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$74.70
|
| Rate for Payer: BCBS POS |
$78.85
|
| Rate for Payer: BCBS Traditional |
$83.00
|
| Rate for Payer: CASH_PRICE |
$66.40
|
| Rate for Payer: CIGNA Commercial |
$78.85
|
| Rate for Payer: CIGNA Medicare |
$74.70
|
| Rate for Payer: HUMANA Commercial |
$74.70
|
| Rate for Payer: MEDICAID Medicaid |
$76.36
|
| Rate for Payer: MEDICARE Medicare |
$58.10
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$78.85
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$80.51
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$78.85
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$78.85
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$70.55
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$66.40
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$66.40
|
|
|
LAB M TB PROBE
|
Facility
OP
|
$83.00
|
|
|
Service Code
|
CPT 87555
|
| Hospital Charge Code |
20211001
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$58.10 |
| Max. Negotiated Rate |
$83.00 |
| Rate for Payer: AETNA Commercial |
$78.85
|
| Rate for Payer: AETNA Medicare |
$74.70
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$78.85
|
| Rate for Payer: BCBS Healthlink |
$74.70
|
| Rate for Payer: BCBS HMK CHIP |
$74.70
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$74.70
|
| Rate for Payer: BCBS POS |
$78.85
|
| Rate for Payer: BCBS Traditional |
$83.00
|
| Rate for Payer: CASH_PRICE |
$66.40
|
| Rate for Payer: CIGNA Commercial |
$78.85
|
| Rate for Payer: CIGNA Medicare |
$74.70
|
| Rate for Payer: HUMANA Commercial |
$74.70
|
| Rate for Payer: MEDICAID Medicaid |
$76.36
|
| Rate for Payer: MEDICARE Medicare |
$58.10
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$78.85
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$80.51
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$78.85
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$78.85
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$70.55
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$66.40
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$66.40
|
|
|
LAB MUCIN CLOT
|
Facility
IP
|
$40.00
|
|
|
Service Code
|
CPT 83872
|
| Hospital Charge Code |
20211001
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$28.00 |
| Max. Negotiated Rate |
$40.00 |
| Rate for Payer: AETNA Commercial |
$38.00
|
| Rate for Payer: AETNA Medicare |
$36.00
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$38.00
|
| Rate for Payer: BCBS Healthlink |
$36.00
|
| Rate for Payer: BCBS HMK CHIP |
$36.00
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$36.00
|
| Rate for Payer: BCBS POS |
$38.00
|
| Rate for Payer: BCBS Traditional |
$40.00
|
| Rate for Payer: CASH_PRICE |
$32.00
|
| Rate for Payer: CIGNA Commercial |
$38.00
|
| Rate for Payer: CIGNA Medicare |
$36.00
|
| Rate for Payer: HUMANA Commercial |
$36.00
|
| Rate for Payer: MEDICAID Medicaid |
$36.80
|
| Rate for Payer: MEDICARE Medicare |
$28.00
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$38.00
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$38.80
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$38.00
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$38.00
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$34.00
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$32.00
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$32.00
|
|
|
LAB MUCIN CLOT
|
Facility
OP
|
$40.00
|
|
|
Service Code
|
CPT 83872
|
| Hospital Charge Code |
20211001
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$28.00 |
| Max. Negotiated Rate |
$40.00 |
| Rate for Payer: AETNA Commercial |
$38.00
|
| Rate for Payer: AETNA Medicare |
$36.00
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$38.00
|
| Rate for Payer: BCBS Healthlink |
$36.00
|
| Rate for Payer: BCBS HMK CHIP |
$36.00
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$36.00
|
| Rate for Payer: BCBS POS |
$38.00
|
| Rate for Payer: BCBS Traditional |
$40.00
|
| Rate for Payer: CASH_PRICE |
$32.00
|
| Rate for Payer: CIGNA Commercial |
$38.00
|
| Rate for Payer: CIGNA Medicare |
$36.00
|
| Rate for Payer: HUMANA Commercial |
$36.00
|
| Rate for Payer: MEDICAID Medicaid |
$36.80
|
| Rate for Payer: MEDICARE Medicare |
$28.00
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$38.00
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$38.80
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$38.00
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$38.00
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$34.00
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$32.00
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$32.00
|
|
|
LAB MULTIALLERGEN SCREEN
|
Facility
OP
|
$76.00
|
|
|
Service Code
|
CPT 86005
|
| Hospital Charge Code |
20211001
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$53.20 |
| Max. Negotiated Rate |
$76.00 |
| Rate for Payer: AETNA Commercial |
$72.20
|
| Rate for Payer: AETNA Medicare |
$68.40
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$72.20
|
| Rate for Payer: BCBS Healthlink |
$68.40
|
| Rate for Payer: BCBS HMK CHIP |
$68.40
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$68.40
|
| Rate for Payer: BCBS POS |
$72.20
|
| Rate for Payer: BCBS Traditional |
$76.00
|
| Rate for Payer: CASH_PRICE |
$60.80
|
| Rate for Payer: CIGNA Commercial |
$72.20
|
| Rate for Payer: CIGNA Medicare |
$68.40
|
| Rate for Payer: HUMANA Commercial |
$68.40
|
| Rate for Payer: MEDICAID Medicaid |
$69.92
|
| Rate for Payer: MEDICARE Medicare |
$53.20
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$72.20
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$73.72
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$72.20
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$72.20
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$64.60
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$60.80
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$60.80
|
|
