|
LAB SERUM NICKEL
|
Facility
IP
|
$83.00
|
|
|
Service Code
|
CPT 83885
|
| Hospital Charge Code |
20211001
|
|
Hospital Revenue Code
|
301
|
| 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 SERUM NICKEL
|
Facility
OP
|
$83.00
|
|
|
Service Code
|
CPT 83885
|
| Hospital Charge Code |
20211001
|
|
Hospital Revenue Code
|
301
|
| 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 SHIGALIKE TOXIN
|
Facility
IP
|
$119.00
|
|
|
Service Code
|
CPT 87449
|
| Hospital Charge Code |
20211001
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$83.30 |
| Max. Negotiated Rate |
$119.00 |
| Rate for Payer: BCBS HMK CHIP |
$107.10
|
| Rate for Payer: AETNA Commercial |
$113.05
|
| Rate for Payer: AETNA Medicare |
$107.10
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$113.05
|
| Rate for Payer: BCBS Healthlink |
$107.10
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$107.10
|
| Rate for Payer: BCBS POS |
$113.05
|
| Rate for Payer: BCBS Traditional |
$119.00
|
| Rate for Payer: CASH_PRICE |
$95.20
|
| Rate for Payer: CIGNA Commercial |
$113.05
|
| Rate for Payer: CIGNA Medicare |
$107.10
|
| Rate for Payer: HUMANA Commercial |
$107.10
|
| Rate for Payer: MEDICAID Medicaid |
$109.48
|
| Rate for Payer: MEDICARE Medicare |
$83.30
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$113.05
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$115.43
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$113.05
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$113.05
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$101.15
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$95.20
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$95.20
|
|
|
LAB SHIGALIKE TOXIN
|
Facility
OP
|
$119.00
|
|
|
Service Code
|
CPT 87449
|
| Hospital Charge Code |
20211001
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$83.30 |
| Max. Negotiated Rate |
$119.00 |
| Rate for Payer: AETNA Commercial |
$113.05
|
| Rate for Payer: AETNA Medicare |
$107.10
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$113.05
|
| Rate for Payer: BCBS Healthlink |
$107.10
|
| Rate for Payer: BCBS HMK CHIP |
$107.10
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$107.10
|
| Rate for Payer: BCBS POS |
$113.05
|
| Rate for Payer: BCBS Traditional |
$119.00
|
| Rate for Payer: CASH_PRICE |
$95.20
|
| Rate for Payer: CIGNA Commercial |
$113.05
|
| Rate for Payer: CIGNA Medicare |
$107.10
|
| Rate for Payer: HUMANA Commercial |
$107.10
|
| Rate for Payer: MEDICAID Medicaid |
$109.48
|
| Rate for Payer: MEDICARE Medicare |
$83.30
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$113.05
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$115.43
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$113.05
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$113.05
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$101.15
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$95.20
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$95.20
|
|
|
LAB SKIN CULTURE
|
Facility
IP
|
$99.00
|
|
|
Service Code
|
CPT 87101
|
| Hospital Charge Code |
20211001
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$69.30 |
| Max. Negotiated Rate |
$99.00 |
| Rate for Payer: AETNA Commercial |
$94.05
|
| Rate for Payer: AETNA Medicare |
$89.10
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$94.05
|
| Rate for Payer: BCBS Healthlink |
$89.10
|
| Rate for Payer: BCBS HMK CHIP |
$89.10
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$89.10
|
| Rate for Payer: BCBS POS |
$94.05
|
| Rate for Payer: BCBS Traditional |
$99.00
|
| Rate for Payer: CASH_PRICE |
$79.20
|
| Rate for Payer: CIGNA Commercial |
$94.05
|
| Rate for Payer: CIGNA Medicare |
$89.10
|
| Rate for Payer: HUMANA Commercial |
$89.10
|
| Rate for Payer: MEDICAID Medicaid |
$91.08
|
| Rate for Payer: MEDICARE Medicare |
$69.30
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$94.05
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$96.03
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$94.05
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$94.05
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$84.15
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$79.20
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$79.20
|
|
|
LAB SKIN CULTURE
|
Facility
OP
|
$99.00
|
|
|
Service Code
|
CPT 87101
|
| Hospital Charge Code |
20211001
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$69.30 |
| Max. Negotiated Rate |
$99.00 |
| Rate for Payer: AETNA Commercial |
$94.05
|
| Rate for Payer: AETNA Medicare |
$89.10
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$94.05
|
| Rate for Payer: BCBS Healthlink |
$89.10
|
| Rate for Payer: BCBS HMK CHIP |
$89.10
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$89.10
|
| Rate for Payer: BCBS POS |
$94.05
|
| Rate for Payer: BCBS Traditional |
$99.00
|
| Rate for Payer: CASH_PRICE |
$79.20
|
| Rate for Payer: CIGNA Commercial |
$94.05
|
| Rate for Payer: CIGNA Medicare |
$89.10
|
| Rate for Payer: HUMANA Commercial |
$89.10
|
| Rate for Payer: MEDICAID Medicaid |
$91.08
|
| Rate for Payer: MEDICARE Medicare |
$69.30
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$94.05
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$96.03
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$94.05
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$94.05
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$84.15
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$79.20
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$79.20
|
|
|
LAB SMEAR EXAM
|
Facility
IP
|
$42.00
|
|
|
Service Code
|
CPT 85008
|
| Hospital Charge Code |
20211001
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$29.40 |
| Max. Negotiated Rate |
$42.00 |
| Rate for Payer: BCBS HMK CHIP |
$37.80
|
| Rate for Payer: AETNA Commercial |
$39.90
|
| Rate for Payer: AETNA Medicare |
$37.80
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$39.90
|
| Rate for Payer: BCBS Healthlink |
$37.80
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$37.80
|
| Rate for Payer: BCBS POS |
$39.90
|
| Rate for Payer: BCBS Traditional |
$42.00
|
| Rate for Payer: CASH_PRICE |
$33.60
|
| Rate for Payer: CIGNA Commercial |
$39.90
|
| Rate for Payer: CIGNA Medicare |
$37.80
|
| Rate for Payer: HUMANA Commercial |
$37.80
|
| Rate for Payer: MEDICAID Medicaid |
$38.64
|
| Rate for Payer: MEDICARE Medicare |
$29.40
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$39.90
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$40.74
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$39.90
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$39.90
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$35.70
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$33.60
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$33.60
|
|
|
LAB SMEAR EXAM
|
Facility
OP
|
$42.00
|
|
|
Service Code
|
CPT 85008
|
| Hospital Charge Code |
20211001
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$29.40 |
| Max. Negotiated Rate |
$42.00 |
| Rate for Payer: AETNA Commercial |
$39.90
|
| Rate for Payer: AETNA Medicare |
$37.80
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$39.90
|
| Rate for Payer: BCBS Healthlink |
$37.80
|
| Rate for Payer: BCBS HMK CHIP |
$37.80
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$37.80
|
| Rate for Payer: BCBS POS |
$39.90
|
| Rate for Payer: BCBS Traditional |
$42.00
|
| Rate for Payer: CASH_PRICE |
$33.60
|
| Rate for Payer: CIGNA Commercial |
$39.90
|
| Rate for Payer: CIGNA Medicare |
$37.80
|
| Rate for Payer: HUMANA Commercial |
$37.80
|
| Rate for Payer: MEDICAID Medicaid |
$38.64
|
| Rate for Payer: MEDICARE Medicare |
$29.40
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$39.90
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$40.74
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$39.90
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$39.90
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$35.70
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$33.60
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$33.60
|
|
|
LAB SPECIMAN HANDLING
|
Facility
IP
|
$45.00
|
|
|
Service Code
|
CPT 99001
|
| Hospital Charge Code |
20211001
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$31.50 |
| Max. Negotiated Rate |
$45.00 |
| Rate for Payer: AETNA Commercial |
$42.75
|
| Rate for Payer: AETNA Medicare |
$40.50
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$42.75
|
| Rate for Payer: BCBS Healthlink |
$40.50
|
| Rate for Payer: BCBS HMK CHIP |
$40.50
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$40.50
|
| Rate for Payer: BCBS POS |
$42.75
|
| Rate for Payer: BCBS Traditional |
$45.00
|
| Rate for Payer: CASH_PRICE |
$36.00
|
| Rate for Payer: CIGNA Commercial |
$42.75
|
| Rate for Payer: CIGNA Medicare |
$40.50
|
| Rate for Payer: HUMANA Commercial |
$40.50
|
| Rate for Payer: MEDICAID Medicaid |
$41.40
|
| Rate for Payer: MEDICARE Medicare |
$31.50
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$42.75
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$43.65
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$42.75
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$42.75
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$38.25
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$36.00
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$36.00
|
|
|
LAB SPECIMAN HANDLING
|
Facility
OP
|
$45.00
|
|
|
Service Code
|
CPT 99001
|
| Hospital Charge Code |
20211001
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$31.50 |
| Max. Negotiated Rate |
$45.00 |
| Rate for Payer: AETNA Commercial |
$42.75
|
| Rate for Payer: AETNA Medicare |
$40.50
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$42.75
|
| Rate for Payer: BCBS Healthlink |
$40.50
|
| Rate for Payer: BCBS HMK CHIP |
$40.50
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$40.50
|
| Rate for Payer: BCBS POS |
$42.75
|
| Rate for Payer: BCBS Traditional |
$45.00
|
| Rate for Payer: CASH_PRICE |
$36.00
|
| Rate for Payer: CIGNA Commercial |
$42.75
|
| Rate for Payer: CIGNA Medicare |
$40.50
|
| Rate for Payer: HUMANA Commercial |
$40.50
|
| Rate for Payer: MEDICAID Medicaid |
$41.40
|
| Rate for Payer: MEDICARE Medicare |
$31.50
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$42.75
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$43.65
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$42.75
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$42.75
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$38.25
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$36.00
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$36.00
|
|
|
LAB STAPHYLOCOCCAL ENTEROTOXIN A 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 STAPHYLOCOCCAL ENTEROTOXIN A 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 STAPHYLOCOCCAL ENTEROTOXIN B 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 STAPHYLOCOCCAL ENTEROTOXIN B 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 STRONGYLOIDES SEROLOGY BY EIA
|
Facility
IP
|
$81.00
|
|
|
Service Code
|
CPT 86317
|
| Hospital Charge Code |
20211001
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$56.70 |
| Max. Negotiated Rate |
$81.00 |
| Rate for Payer: BCBS HMK CHIP |
$72.90
|
| Rate for Payer: AETNA Commercial |
$76.95
|
| Rate for Payer: AETNA Medicare |
$72.90
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$76.95
|
| Rate for Payer: BCBS Healthlink |
$72.90
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$72.90
|
| Rate for Payer: BCBS POS |
$76.95
|
| Rate for Payer: BCBS Traditional |
$81.00
|
| Rate for Payer: CASH_PRICE |
$64.80
|
| Rate for Payer: CIGNA Commercial |
$76.95
|
| Rate for Payer: CIGNA Medicare |
$72.90
|
| Rate for Payer: HUMANA Commercial |
$72.90
|
| Rate for Payer: MEDICAID Medicaid |
$74.52
|
| Rate for Payer: MEDICARE Medicare |
$56.70
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$76.95
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$78.57
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$76.95
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$76.95
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$68.85
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$64.80
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$64.80
|
|
|
LAB STRONGYLOIDES SEROLOGY BY EIA
|
Facility
OP
|
$81.00
|
|
|
Service Code
|
CPT 86317
|
| Hospital Charge Code |
20211001
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$56.70 |
| Max. Negotiated Rate |
$81.00 |
| Rate for Payer: AETNA Commercial |
$76.95
|
| Rate for Payer: AETNA Medicare |
$72.90
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$76.95
|
| Rate for Payer: BCBS Healthlink |
$72.90
|
| Rate for Payer: BCBS HMK CHIP |
$72.90
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$72.90
|
| Rate for Payer: BCBS POS |
$76.95
|
| Rate for Payer: BCBS Traditional |
$81.00
|
| Rate for Payer: CASH_PRICE |
$64.80
|
| Rate for Payer: CIGNA Commercial |
$76.95
|
| Rate for Payer: CIGNA Medicare |
$72.90
|
| Rate for Payer: HUMANA Commercial |
$72.90
|
| Rate for Payer: MEDICAID Medicaid |
$74.52
|
| Rate for Payer: MEDICARE Medicare |
$56.70
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$76.95
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$78.57
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$76.95
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$76.95
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$68.85
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$64.80
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$64.80
|
|
|
LAB SURGICAL PATH LEVEL IV
|
Facility
OP
|
$193.00
|
|
|
Service Code
|
CPT 88305
|
| Hospital Charge Code |
20211001
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$135.10 |
| Max. Negotiated Rate |
$193.00 |
| Rate for Payer: AETNA Commercial |
$183.35
|
| Rate for Payer: AETNA Medicare |
$173.70
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$183.35
|
| Rate for Payer: BCBS Healthlink |
$173.70
|
| Rate for Payer: BCBS HMK CHIP |
$173.70
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$173.70
|
| Rate for Payer: BCBS POS |
$183.35
|
| Rate for Payer: BCBS Traditional |
$193.00
|
| Rate for Payer: CASH_PRICE |
$154.40
|
| Rate for Payer: CIGNA Commercial |
$183.35
|
| Rate for Payer: CIGNA Medicare |
$173.70
|
| Rate for Payer: HUMANA Commercial |
$173.70
|
| Rate for Payer: MEDICAID Medicaid |
$177.56
|
| Rate for Payer: MEDICARE Medicare |
$135.10
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$183.35
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$187.21
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$183.35
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$183.35
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$164.05
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$154.40
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$154.40
|
|
|
LAB SURGICAL PATH LEVEL IV
|
Facility
IP
|
$193.00
|
|
|
Service Code
|
CPT 88305
|
| Hospital Charge Code |
20211001
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$135.10 |
| Max. Negotiated Rate |
$193.00 |
| Rate for Payer: AETNA Commercial |
$183.35
|
| Rate for Payer: AETNA Medicare |
$173.70
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$183.35
|
| Rate for Payer: BCBS Healthlink |
$173.70
|
| Rate for Payer: BCBS HMK CHIP |
$173.70
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$173.70
|
| Rate for Payer: BCBS POS |
$183.35
|
| Rate for Payer: BCBS Traditional |
$193.00
|
| Rate for Payer: CASH_PRICE |
$154.40
|
| Rate for Payer: CIGNA Commercial |
$183.35
|
| Rate for Payer: CIGNA Medicare |
$173.70
|
| Rate for Payer: HUMANA Commercial |
$173.70
|
| Rate for Payer: MEDICAID Medicaid |
$177.56
|
| Rate for Payer: MEDICARE Medicare |
$135.10
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$183.35
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$187.21
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$183.35
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$183.35
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$164.05
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$154.40
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$154.40
|
|
|
LAB SUSCEPTIBILTY STUDY ANTIMICROBIAL
|
Facility
IP
|
$76.00
|
|
|
Service Code
|
CPT 87188
|
| Hospital Charge Code |
20211001
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$53.20 |
| Max. Negotiated Rate |
$76.00 |
| Rate for Payer: BCBS HMK CHIP |
$68.40
|
| 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 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
|
|
|
LAB SUSCEPTIBILTY STUDY ANTIMICROBIAL
|
Facility
OP
|
$76.00
|
|
|
Service Code
|
CPT 87188
|
| Hospital Charge Code |
20211001
|
|
Hospital Revenue Code
|
300
|
| 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
|
|
|
LAB SYNOVIAL FLUID GLUCOSE
|
Facility
OP
|
$46.00
|
|
|
Service Code
|
CPT 82945
|
| Hospital Charge Code |
20211001
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$32.20 |
| Max. Negotiated Rate |
$46.00 |
| Rate for Payer: AETNA Commercial |
$43.70
|
| Rate for Payer: AETNA Medicare |
$41.40
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$43.70
|
| Rate for Payer: BCBS Healthlink |
$41.40
|
| Rate for Payer: BCBS HMK CHIP |
$41.40
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$41.40
|
| Rate for Payer: BCBS POS |
$43.70
|
| Rate for Payer: BCBS Traditional |
$46.00
|
| Rate for Payer: CASH_PRICE |
$36.80
|
| Rate for Payer: CIGNA Commercial |
$43.70
|
| Rate for Payer: CIGNA Medicare |
$41.40
|
| Rate for Payer: HUMANA Commercial |
$41.40
|
| Rate for Payer: MEDICAID Medicaid |
$42.32
|
| Rate for Payer: MEDICARE Medicare |
$32.20
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$43.70
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$44.62
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$43.70
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$43.70
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$39.10
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$36.80
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$36.80
|
|
|
LAB SYNOVIAL FLUID GLUCOSE
|
Facility
IP
|
$46.00
|
|
|
Service Code
|
CPT 82945
|
| Hospital Charge Code |
20211001
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$32.20 |
| Max. Negotiated Rate |
$46.00 |
| Rate for Payer: AETNA Commercial |
$43.70
|
| Rate for Payer: AETNA Medicare |
$41.40
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$43.70
|
| Rate for Payer: BCBS Healthlink |
$41.40
|
| Rate for Payer: BCBS HMK CHIP |
$41.40
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$41.40
|
| Rate for Payer: BCBS POS |
$43.70
|
| Rate for Payer: BCBS Traditional |
$46.00
|
| Rate for Payer: CASH_PRICE |
$36.80
|
| Rate for Payer: CIGNA Commercial |
$43.70
|
| Rate for Payer: CIGNA Medicare |
$41.40
|
| Rate for Payer: HUMANA Commercial |
$41.40
|
| Rate for Payer: MEDICAID Medicaid |
$42.32
|
| Rate for Payer: MEDICARE Medicare |
$32.20
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$43.70
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$44.62
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$43.70
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$43.70
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$39.10
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$36.80
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$36.80
|
|
|
LAB SYNOVIAL FLUID PROTEIN
|
Facility
OP
|
$49.00
|
|
|
Service Code
|
CPT 84157
|
| Hospital Charge Code |
20211001
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$34.30 |
| Max. Negotiated Rate |
$49.00 |
| Rate for Payer: AETNA Commercial |
$46.55
|
| Rate for Payer: AETNA Medicare |
$44.10
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$46.55
|
| Rate for Payer: BCBS Healthlink |
$44.10
|
| Rate for Payer: BCBS HMK CHIP |
$44.10
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$44.10
|
| Rate for Payer: BCBS POS |
$46.55
|
| Rate for Payer: BCBS Traditional |
$49.00
|
| Rate for Payer: CASH_PRICE |
$39.20
|
| Rate for Payer: CIGNA Commercial |
$46.55
|
| Rate for Payer: CIGNA Medicare |
$44.10
|
| Rate for Payer: HUMANA Commercial |
$44.10
|
| Rate for Payer: MEDICAID Medicaid |
$45.08
|
| Rate for Payer: MEDICARE Medicare |
$34.30
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$46.55
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$47.53
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$46.55
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$46.55
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$41.65
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$39.20
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$39.20
|
|
|
LAB SYNOVIAL FLUID PROTEIN
|
Facility
IP
|
$49.00
|
|
|
Service Code
|
CPT 84157
|
| Hospital Charge Code |
20211001
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$34.30 |
| Max. Negotiated Rate |
$49.00 |
| Rate for Payer: BCBS HMK CHIP |
$44.10
|
| Rate for Payer: AETNA Commercial |
$46.55
|
| Rate for Payer: AETNA Medicare |
$44.10
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$46.55
|
| Rate for Payer: BCBS Healthlink |
$44.10
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$44.10
|
| Rate for Payer: BCBS POS |
$46.55
|
| Rate for Payer: BCBS Traditional |
$49.00
|
| Rate for Payer: CASH_PRICE |
$39.20
|
| Rate for Payer: CIGNA Commercial |
$46.55
|
| Rate for Payer: CIGNA Medicare |
$44.10
|
| Rate for Payer: HUMANA Commercial |
$44.10
|
| Rate for Payer: MEDICAID Medicaid |
$45.08
|
| Rate for Payer: MEDICARE Medicare |
$34.30
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$46.55
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$47.53
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$46.55
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$46.55
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$41.65
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$39.20
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$39.20
|
|
|
LAB THEOPHYLLINE
|
Facility
OP
|
$104.00
|
|
|
Service Code
|
CPT 80198
|
| Hospital Charge Code |
20211001
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$72.80 |
| Max. Negotiated Rate |
$104.00 |
| Rate for Payer: AETNA Commercial |
$98.80
|
| Rate for Payer: AETNA Medicare |
$93.60
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$98.80
|
| Rate for Payer: BCBS Healthlink |
$93.60
|
| Rate for Payer: BCBS HMK CHIP |
$93.60
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$93.60
|
| Rate for Payer: BCBS POS |
$98.80
|
| Rate for Payer: BCBS Traditional |
$104.00
|
| Rate for Payer: CASH_PRICE |
$83.20
|
| Rate for Payer: CIGNA Commercial |
$98.80
|
| Rate for Payer: CIGNA Medicare |
$93.60
|
| Rate for Payer: HUMANA Commercial |
$93.60
|
| Rate for Payer: MEDICAID Medicaid |
$95.68
|
| Rate for Payer: MEDICARE Medicare |
$72.80
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$98.80
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$100.88
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$98.80
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$98.80
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$88.40
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$83.20
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$83.20
|
|
