|
OXYTOCIN INJ [10 U/ML]
|
Facility
OP
|
$26.00
|
|
|
Service Code
|
CPT J3490
|
| Hospital Charge Code |
20221105
|
|
Hospital Revenue Code
|
259
|
| 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
|
|
|
PAIN ROOM FACILITY LEVEL 2
|
Facility
IP
|
$3,356.00
|
|
| Hospital Charge Code |
20221105
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,349.20 |
| Max. Negotiated Rate |
$3,356.00 |
| Rate for Payer: AETNA Commercial |
$3,188.20
|
| Rate for Payer: AETNA Medicare |
$3,020.40
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$3,188.20
|
| Rate for Payer: BCBS Healthlink |
$3,020.40
|
| Rate for Payer: BCBS HMK CHIP |
$3,020.40
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$3,020.40
|
| Rate for Payer: BCBS POS |
$3,188.20
|
| Rate for Payer: BCBS Traditional |
$3,356.00
|
| Rate for Payer: CASH_PRICE |
$2,684.80
|
| Rate for Payer: CIGNA Commercial |
$3,188.20
|
| Rate for Payer: CIGNA Medicare |
$3,020.40
|
| Rate for Payer: HUMANA Commercial |
$3,020.40
|
| Rate for Payer: MEDICAID Medicaid |
$3,087.52
|
| Rate for Payer: MEDICARE Medicare |
$2,349.20
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$3,188.20
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$3,255.32
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$3,188.20
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$3,188.20
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$2,852.60
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$2,684.80
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$2,684.80
|
|
|
PAIN ROOM FACILITY LEVEL 2
|
Facility
OP
|
$3,356.00
|
|
| Hospital Charge Code |
20221105
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,349.20 |
| Max. Negotiated Rate |
$3,356.00 |
| Rate for Payer: AETNA Commercial |
$3,188.20
|
| Rate for Payer: AETNA Medicare |
$3,020.40
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$3,188.20
|
| Rate for Payer: BCBS Healthlink |
$3,020.40
|
| Rate for Payer: BCBS HMK CHIP |
$3,020.40
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$3,020.40
|
| Rate for Payer: BCBS POS |
$3,188.20
|
| Rate for Payer: BCBS Traditional |
$3,356.00
|
| Rate for Payer: CASH_PRICE |
$2,684.80
|
| Rate for Payer: CIGNA Commercial |
$3,188.20
|
| Rate for Payer: CIGNA Medicare |
$3,020.40
|
| Rate for Payer: HUMANA Commercial |
$3,020.40
|
| Rate for Payer: MEDICAID Medicaid |
$3,087.52
|
| Rate for Payer: MEDICARE Medicare |
$2,349.20
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$3,188.20
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$3,255.32
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$3,188.20
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$3,188.20
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$2,852.60
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$2,684.80
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$2,684.80
|
|
|
PAIN ROOM FACILITY LEVEL 3
|
Facility
IP
|
$4,254.00
|
|
| Hospital Charge Code |
20221105
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,977.80 |
| Max. Negotiated Rate |
$4,254.00 |
| Rate for Payer: AETNA Commercial |
$4,041.30
|
| Rate for Payer: AETNA Medicare |
$3,828.60
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$4,041.30
|
| Rate for Payer: BCBS Healthlink |
$3,828.60
|
| Rate for Payer: BCBS HMK CHIP |
$3,828.60
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$3,828.60
|
| Rate for Payer: BCBS POS |
$4,041.30
|
| Rate for Payer: BCBS Traditional |
$4,254.00
|
| Rate for Payer: CASH_PRICE |
$3,403.20
|
| Rate for Payer: CIGNA Commercial |
$4,041.30
|
| Rate for Payer: CIGNA Medicare |
$3,828.60
|
| Rate for Payer: HUMANA Commercial |
$3,828.60
|
| Rate for Payer: MEDICAID Medicaid |
$3,913.68
|
| Rate for Payer: MEDICARE Medicare |
$2,977.80
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$4,041.30
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$4,126.38
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$4,041.30
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$4,041.30
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$3,615.90
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$3,403.20
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$3,403.20
|
|
|
PAIN ROOM FACILITY LEVEL 3
|
Facility
OP
|
$4,254.00
|
|
| Hospital Charge Code |
20221105
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,977.80 |
| Max. Negotiated Rate |
$4,254.00 |
| Rate for Payer: AETNA Commercial |
$4,041.30
|
| Rate for Payer: AETNA Medicare |
$3,828.60
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$4,041.30
|
| Rate for Payer: BCBS Healthlink |
$3,828.60
|
| Rate for Payer: BCBS HMK CHIP |
$3,828.60
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$3,828.60
|
| Rate for Payer: BCBS POS |
$4,041.30
|
| Rate for Payer: BCBS Traditional |
$4,254.00
|
| Rate for Payer: CASH_PRICE |
$3,403.20
|
| Rate for Payer: CIGNA Commercial |
$4,041.30
|
| Rate for Payer: CIGNA Medicare |
$3,828.60
|
| Rate for Payer: HUMANA Commercial |
$3,828.60
|
| Rate for Payer: MEDICAID Medicaid |
$3,913.68
|
| Rate for Payer: MEDICARE Medicare |
$2,977.80
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$4,041.30
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$4,126.38
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$4,041.30
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$4,041.30
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$3,615.90
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$3,403.20
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$3,403.20
|
|
|
PANCREATIC ELASTASE, STOOL (123234)
|
Facility
OP
|
$551.00
|
|
|
Service Code
|
CPT 82653
|
| Hospital Charge Code |
20221105
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$385.70 |
| Max. Negotiated Rate |
$551.00 |
| Rate for Payer: AETNA Commercial |
$523.45
|
| Rate for Payer: AETNA Medicare |
$495.90
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$523.45
|
| Rate for Payer: BCBS Healthlink |
$495.90
|
| Rate for Payer: BCBS HMK CHIP |
$495.90
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$495.90
|
| Rate for Payer: BCBS POS |
$523.45
|
| Rate for Payer: BCBS Traditional |
$551.00
|
| Rate for Payer: CASH_PRICE |
$440.80
|
| Rate for Payer: CIGNA Commercial |
$523.45
|
| Rate for Payer: CIGNA Medicare |
$495.90
|
| Rate for Payer: HUMANA Commercial |
$495.90
|
| Rate for Payer: MEDICAID Medicaid |
$506.92
|
| Rate for Payer: MEDICARE Medicare |
$385.70
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$523.45
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$534.47
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$523.45
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$523.45
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$468.35
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$440.80
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$440.80
|
|
|
PANCREATIC ELASTASE, STOOL (123234)
|
Facility
IP
|
$551.00
|
|
|
Service Code
|
CPT 82653
|
| Hospital Charge Code |
20221105
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$385.70 |
| Max. Negotiated Rate |
$551.00 |
| Rate for Payer: AETNA Commercial |
$523.45
|
| Rate for Payer: AETNA Medicare |
$495.90
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$523.45
|
| Rate for Payer: BCBS Healthlink |
$495.90
|
| Rate for Payer: BCBS HMK CHIP |
$495.90
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$495.90
|
| Rate for Payer: BCBS POS |
$523.45
|
| Rate for Payer: BCBS Traditional |
$551.00
|
| Rate for Payer: CASH_PRICE |
$440.80
|
| Rate for Payer: CIGNA Commercial |
$523.45
|
| Rate for Payer: CIGNA Medicare |
$495.90
|
| Rate for Payer: HUMANA Commercial |
$495.90
|
| Rate for Payer: MEDICAID Medicaid |
$506.92
|
| Rate for Payer: MEDICARE Medicare |
$385.70
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$523.45
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$534.47
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$523.45
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$523.45
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$468.35
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$440.80
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$440.80
|
|
|
PANTOPRAZOLE INJ [40MG]
|
Facility
OP
|
$26.00
|
|
|
Service Code
|
CPT C9113
|
| Hospital Charge Code |
20221105
|
|
Hospital Revenue Code
|
259
|
| 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
|
|
|
PANTOPRAZOLE INJ [40MG]
|
Facility
IP
|
$26.00
|
|
|
Service Code
|
CPT C9113
|
| Hospital Charge Code |
20221105
|
|
Hospital Revenue Code
|
259
|
| 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
|
|
|
PANTOPRAZOLE TAB [40 MG]
|
Facility
OP
|
$8.00
|
|
|
Service Code
|
CPT J3490
|
| Hospital Charge Code |
20221105
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$5.60 |
| Max. Negotiated Rate |
$8.00 |
| Rate for Payer: AETNA Commercial |
$7.60
|
| Rate for Payer: AETNA Medicare |
$7.20
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$7.60
|
| Rate for Payer: BCBS Healthlink |
$7.20
|
| Rate for Payer: BCBS HMK CHIP |
$7.20
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$7.20
|
| Rate for Payer: BCBS POS |
$7.60
|
| Rate for Payer: BCBS Traditional |
$8.00
|
| Rate for Payer: CASH_PRICE |
$6.40
|
| Rate for Payer: CIGNA Commercial |
$7.60
|
| Rate for Payer: CIGNA Medicare |
$7.20
|
| Rate for Payer: HUMANA Commercial |
$7.20
|
| Rate for Payer: MEDICAID Medicaid |
$7.36
|
| Rate for Payer: MEDICARE Medicare |
$5.60
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$7.60
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$7.76
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$7.60
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$7.60
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$6.80
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$6.40
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$6.40
|
|
|
PANTOPRAZOLE TAB [40 MG]
|
Facility
IP
|
$8.00
|
|
|
Service Code
|
CPT J3490
|
| Hospital Charge Code |
20221105
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$5.60 |
| Max. Negotiated Rate |
$8.00 |
| Rate for Payer: AETNA Commercial |
$7.60
|
| Rate for Payer: AETNA Medicare |
$7.20
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$7.60
|
| Rate for Payer: BCBS Healthlink |
$7.20
|
| Rate for Payer: BCBS HMK CHIP |
$7.20
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$7.20
|
| Rate for Payer: BCBS POS |
$7.60
|
| Rate for Payer: BCBS Traditional |
$8.00
|
| Rate for Payer: CASH_PRICE |
$6.40
|
| Rate for Payer: CIGNA Commercial |
$7.60
|
| Rate for Payer: CIGNA Medicare |
$7.20
|
| Rate for Payer: HUMANA Commercial |
$7.20
|
| Rate for Payer: MEDICAID Medicaid |
$7.36
|
| Rate for Payer: MEDICARE Medicare |
$5.60
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$7.60
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$7.76
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$7.60
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$7.60
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$6.80
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$6.40
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$6.40
|
|
|
PAP SMEAR AUTO SCREEN(W/MANUAL REVIEW)
|
Facility
IP
|
$99.00
|
|
|
Service Code
|
CPT 88175
|
| Hospital Charge Code |
20221105
|
|
Hospital Revenue Code
|
521
|
| 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
|
|
|
PAP SMEAR AUTO SCREEN(W/MANUAL REVIEW)
|
Facility
OP
|
$99.00
|
|
|
Service Code
|
CPT 88175
|
| Hospital Charge Code |
20221105
|
|
Hospital Revenue Code
|
521
|
| 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
|
|
|
PARATHYROID HORMONE, INTACT (015610)
|
Facility
OP
|
$33.00
|
|
|
Service Code
|
CPT 83970
|
| Hospital Charge Code |
20221105
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$23.10 |
| Max. Negotiated Rate |
$33.00 |
| Rate for Payer: AETNA Commercial |
$31.35
|
| Rate for Payer: AETNA Medicare |
$29.70
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$31.35
|
| Rate for Payer: BCBS Healthlink |
$29.70
|
| Rate for Payer: BCBS HMK CHIP |
$29.70
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$29.70
|
| Rate for Payer: BCBS POS |
$31.35
|
| Rate for Payer: BCBS Traditional |
$33.00
|
| Rate for Payer: CASH_PRICE |
$26.40
|
| Rate for Payer: CIGNA Commercial |
$31.35
|
| Rate for Payer: CIGNA Medicare |
$29.70
|
| Rate for Payer: HUMANA Commercial |
$29.70
|
| Rate for Payer: MEDICAID Medicaid |
$30.36
|
| Rate for Payer: MEDICARE Medicare |
$23.10
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$31.35
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$32.01
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$31.35
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$31.35
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$28.05
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$26.40
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$26.40
|
|
|
PARATHYROID HORMONE, INTACT (015610)
|
Facility
IP
|
$33.00
|
|
|
Service Code
|
CPT 83970
|
| Hospital Charge Code |
20221105
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$23.10 |
| Max. Negotiated Rate |
$33.00 |
| Rate for Payer: AETNA Commercial |
$31.35
|
| Rate for Payer: AETNA Medicare |
$29.70
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$31.35
|
| Rate for Payer: BCBS Healthlink |
$29.70
|
| Rate for Payer: BCBS HMK CHIP |
$29.70
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$29.70
|
| Rate for Payer: BCBS POS |
$31.35
|
| Rate for Payer: BCBS Traditional |
$33.00
|
| Rate for Payer: CASH_PRICE |
$26.40
|
| Rate for Payer: CIGNA Commercial |
$31.35
|
| Rate for Payer: CIGNA Medicare |
$29.70
|
| Rate for Payer: HUMANA Commercial |
$29.70
|
| Rate for Payer: MEDICAID Medicaid |
$30.36
|
| Rate for Payer: MEDICARE Medicare |
$23.10
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$31.35
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$32.01
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$31.35
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$31.35
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$28.05
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$26.40
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$26.40
|
|
|
PARING/CUTTING 2-4 LESION CORN/CALL
|
Facility
OP
|
$180.00
|
|
|
Service Code
|
CPT 11056
|
| Hospital Charge Code |
20221105
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$126.00 |
| Max. Negotiated Rate |
$180.00 |
| Rate for Payer: AETNA Commercial |
$171.00
|
| Rate for Payer: AETNA Medicare |
$162.00
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$171.00
|
| Rate for Payer: BCBS Healthlink |
$162.00
|
| Rate for Payer: BCBS HMK CHIP |
$162.00
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$162.00
|
| Rate for Payer: BCBS POS |
$171.00
|
| Rate for Payer: BCBS Traditional |
$180.00
|
| Rate for Payer: CASH_PRICE |
$144.00
|
| Rate for Payer: CIGNA Commercial |
$171.00
|
| Rate for Payer: CIGNA Medicare |
$162.00
|
| Rate for Payer: HUMANA Commercial |
$162.00
|
| Rate for Payer: MEDICAID Medicaid |
$165.60
|
| Rate for Payer: MEDICARE Medicare |
$126.00
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$171.00
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$174.60
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$171.00
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$171.00
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$153.00
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$144.00
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$144.00
|
|
|
PARING/CUTTING 2-4 LESION CORN/CALL
|
Facility
IP
|
$180.00
|
|
|
Service Code
|
CPT 11056
|
| Hospital Charge Code |
20221105
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$126.00 |
| Max. Negotiated Rate |
$180.00 |
| Rate for Payer: AETNA Commercial |
$171.00
|
| Rate for Payer: AETNA Medicare |
$162.00
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$171.00
|
| Rate for Payer: BCBS Healthlink |
$162.00
|
| Rate for Payer: BCBS HMK CHIP |
$162.00
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$162.00
|
| Rate for Payer: BCBS POS |
$171.00
|
| Rate for Payer: BCBS Traditional |
$180.00
|
| Rate for Payer: CASH_PRICE |
$144.00
|
| Rate for Payer: CIGNA Commercial |
$171.00
|
| Rate for Payer: CIGNA Medicare |
$162.00
|
| Rate for Payer: HUMANA Commercial |
$162.00
|
| Rate for Payer: MEDICAID Medicaid |
$165.60
|
| Rate for Payer: MEDICARE Medicare |
$126.00
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$171.00
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$174.60
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$171.00
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$171.00
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$153.00
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$144.00
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$144.00
|
|
|
PARING/CUTTING >4 LESIONS CORN/CALLUS
|
Facility
IP
|
$208.00
|
|
|
Service Code
|
CPT 11057
|
| Hospital Charge Code |
20221105
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$145.60 |
| Max. Negotiated Rate |
$208.00 |
| Rate for Payer: AETNA Commercial |
$197.60
|
| Rate for Payer: AETNA Medicare |
$187.20
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$197.60
|
| Rate for Payer: BCBS Healthlink |
$187.20
|
| Rate for Payer: BCBS HMK CHIP |
$187.20
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$187.20
|
| Rate for Payer: BCBS POS |
$197.60
|
| Rate for Payer: BCBS Traditional |
$208.00
|
| Rate for Payer: CASH_PRICE |
$166.40
|
| Rate for Payer: CIGNA Commercial |
$197.60
|
| Rate for Payer: CIGNA Medicare |
$187.20
|
| Rate for Payer: HUMANA Commercial |
$187.20
|
| Rate for Payer: MEDICAID Medicaid |
$191.36
|
| Rate for Payer: MEDICARE Medicare |
$145.60
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$197.60
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$201.76
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$197.60
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$197.60
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$176.80
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$166.40
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$166.40
|
|
|
PARING/CUTTING >4 LESIONS CORN/CALLUS
|
Facility
OP
|
$208.00
|
|
|
Service Code
|
CPT 11057
|
| Hospital Charge Code |
20221105
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$145.60 |
| Max. Negotiated Rate |
$208.00 |
| Rate for Payer: AETNA Commercial |
$197.60
|
| Rate for Payer: AETNA Medicare |
$187.20
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$197.60
|
| Rate for Payer: BCBS Healthlink |
$187.20
|
| Rate for Payer: BCBS HMK CHIP |
$187.20
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$187.20
|
| Rate for Payer: BCBS POS |
$197.60
|
| Rate for Payer: BCBS Traditional |
$208.00
|
| Rate for Payer: CASH_PRICE |
$166.40
|
| Rate for Payer: CIGNA Commercial |
$197.60
|
| Rate for Payer: CIGNA Medicare |
$187.20
|
| Rate for Payer: HUMANA Commercial |
$187.20
|
| Rate for Payer: MEDICAID Medicaid |
$191.36
|
| Rate for Payer: MEDICARE Medicare |
$145.60
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$197.60
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$201.76
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$197.60
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$197.60
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$176.80
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$166.40
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$166.40
|
|
|
PARING/CUTTING SINGLE LESION CORN/CALLUS
|
Facility
OP
|
$166.00
|
|
|
Service Code
|
CPT 11055
|
| Hospital Charge Code |
20221105
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$116.20 |
| Max. Negotiated Rate |
$166.00 |
| Rate for Payer: AETNA Commercial |
$157.70
|
| Rate for Payer: AETNA Medicare |
$149.40
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$157.70
|
| Rate for Payer: BCBS Healthlink |
$149.40
|
| Rate for Payer: BCBS HMK CHIP |
$149.40
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$149.40
|
| Rate for Payer: BCBS POS |
$157.70
|
| Rate for Payer: BCBS Traditional |
$166.00
|
| Rate for Payer: CASH_PRICE |
$132.80
|
| Rate for Payer: CIGNA Commercial |
$157.70
|
| Rate for Payer: CIGNA Medicare |
$149.40
|
| Rate for Payer: HUMANA Commercial |
$149.40
|
| Rate for Payer: MEDICAID Medicaid |
$152.72
|
| Rate for Payer: MEDICARE Medicare |
$116.20
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$157.70
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$161.02
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$157.70
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$157.70
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$141.10
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$132.80
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$132.80
|
|
|
PARING/CUTTING SINGLE LESION CORN/CALLUS
|
Facility
IP
|
$166.00
|
|
|
Service Code
|
CPT 11055
|
| Hospital Charge Code |
20221105
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$116.20 |
| Max. Negotiated Rate |
$166.00 |
| Rate for Payer: AETNA Commercial |
$157.70
|
| Rate for Payer: AETNA Medicare |
$149.40
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$157.70
|
| Rate for Payer: BCBS Healthlink |
$149.40
|
| Rate for Payer: BCBS HMK CHIP |
$149.40
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$149.40
|
| Rate for Payer: BCBS POS |
$157.70
|
| Rate for Payer: BCBS Traditional |
$166.00
|
| Rate for Payer: CASH_PRICE |
$132.80
|
| Rate for Payer: CIGNA Commercial |
$157.70
|
| Rate for Payer: CIGNA Medicare |
$149.40
|
| Rate for Payer: HUMANA Commercial |
$149.40
|
| Rate for Payer: MEDICAID Medicaid |
$152.72
|
| Rate for Payer: MEDICARE Medicare |
$116.20
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$157.70
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$161.02
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$157.70
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$157.70
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$141.10
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$132.80
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$132.80
|
|
|
PAROXETINE TAB [20 MG]
|
Facility
OP
|
$9.00
|
|
|
Service Code
|
CPT J3490
|
| Hospital Charge Code |
20221105
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$6.30 |
| Max. Negotiated Rate |
$9.00 |
| Rate for Payer: AETNA Commercial |
$8.55
|
| Rate for Payer: AETNA Medicare |
$8.10
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$8.55
|
| Rate for Payer: BCBS Healthlink |
$8.10
|
| Rate for Payer: BCBS HMK CHIP |
$8.10
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$8.10
|
| Rate for Payer: BCBS POS |
$8.55
|
| Rate for Payer: BCBS Traditional |
$9.00
|
| Rate for Payer: CASH_PRICE |
$7.20
|
| Rate for Payer: CIGNA Commercial |
$8.55
|
| Rate for Payer: CIGNA Medicare |
$8.10
|
| Rate for Payer: HUMANA Commercial |
$8.10
|
| Rate for Payer: MEDICAID Medicaid |
$8.28
|
| Rate for Payer: MEDICARE Medicare |
$6.30
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$8.55
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$8.73
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$8.55
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$8.55
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$7.65
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$7.20
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$7.20
|
|
|
PAROXETINE TAB [20 MG]
|
Facility
IP
|
$9.00
|
|
|
Service Code
|
CPT J3490
|
| Hospital Charge Code |
20221105
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$6.30 |
| Max. Negotiated Rate |
$9.00 |
| Rate for Payer: AETNA Commercial |
$8.55
|
| Rate for Payer: AETNA Medicare |
$8.10
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$8.55
|
| Rate for Payer: BCBS Healthlink |
$8.10
|
| Rate for Payer: BCBS HMK CHIP |
$8.10
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$8.10
|
| Rate for Payer: BCBS POS |
$8.55
|
| Rate for Payer: BCBS Traditional |
$9.00
|
| Rate for Payer: CASH_PRICE |
$7.20
|
| Rate for Payer: CIGNA Commercial |
$8.55
|
| Rate for Payer: CIGNA Medicare |
$8.10
|
| Rate for Payer: HUMANA Commercial |
$8.10
|
| Rate for Payer: MEDICAID Medicaid |
$8.28
|
| Rate for Payer: MEDICARE Medicare |
$6.30
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$8.55
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$8.73
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$8.55
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$8.55
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$7.65
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$7.20
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$7.20
|
|
|
PATELLA STRAP LG
|
Facility
OP
|
$43.00
|
|
| Hospital Charge Code |
20221105
|
|
Hospital Revenue Code
|
290
|
| Min. Negotiated Rate |
$30.10 |
| Max. Negotiated Rate |
$43.00 |
| Rate for Payer: AETNA Commercial |
$40.85
|
| Rate for Payer: AETNA Medicare |
$38.70
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$40.85
|
| Rate for Payer: BCBS Healthlink |
$38.70
|
| Rate for Payer: BCBS HMK CHIP |
$38.70
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$38.70
|
| Rate for Payer: BCBS POS |
$40.85
|
| Rate for Payer: BCBS Traditional |
$43.00
|
| Rate for Payer: CASH_PRICE |
$34.40
|
| Rate for Payer: CIGNA Commercial |
$40.85
|
| Rate for Payer: CIGNA Medicare |
$38.70
|
| Rate for Payer: HUMANA Commercial |
$38.70
|
| Rate for Payer: MEDICAID Medicaid |
$39.56
|
| Rate for Payer: MEDICARE Medicare |
$30.10
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$40.85
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$41.71
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$40.85
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$40.85
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$36.55
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$34.40
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$34.40
|
|
|
PATELLA STRAP LG
|
Facility
IP
|
$43.00
|
|
| Hospital Charge Code |
20221105
|
|
Hospital Revenue Code
|
290
|
| Min. Negotiated Rate |
$30.10 |
| Max. Negotiated Rate |
$43.00 |
| Rate for Payer: AETNA Commercial |
$40.85
|
| Rate for Payer: AETNA Medicare |
$38.70
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$40.85
|
| Rate for Payer: BCBS Healthlink |
$38.70
|
| Rate for Payer: BCBS HMK CHIP |
$38.70
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$38.70
|
| Rate for Payer: BCBS POS |
$40.85
|
| Rate for Payer: BCBS Traditional |
$43.00
|
| Rate for Payer: CASH_PRICE |
$34.40
|
| Rate for Payer: CIGNA Commercial |
$40.85
|
| Rate for Payer: CIGNA Medicare |
$38.70
|
| Rate for Payer: HUMANA Commercial |
$38.70
|
| Rate for Payer: MEDICAID Medicaid |
$39.56
|
| Rate for Payer: MEDICARE Medicare |
$30.10
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$40.85
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$41.71
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$40.85
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$40.85
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$36.55
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$34.40
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$34.40
|
|
