|
ST EVAL SPEECH SOUND PRODUCTION
|
Facility
OP
|
$332.00
|
|
|
Service Code
|
CPT 92522 GN
|
| Hospital Charge Code |
20221105
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$232.40 |
| Max. Negotiated Rate |
$332.00 |
| Rate for Payer: AETNA Commercial |
$315.40
|
| Rate for Payer: AETNA Medicare |
$298.80
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$315.40
|
| Rate for Payer: BCBS Healthlink |
$298.80
|
| Rate for Payer: BCBS HMK CHIP |
$298.80
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$298.80
|
| Rate for Payer: BCBS POS |
$315.40
|
| Rate for Payer: BCBS Traditional |
$332.00
|
| Rate for Payer: CASH_PRICE |
$265.60
|
| Rate for Payer: CIGNA Commercial |
$315.40
|
| Rate for Payer: CIGNA Medicare |
$298.80
|
| Rate for Payer: HUMANA Commercial |
$298.80
|
| Rate for Payer: MEDICAID Medicaid |
$305.44
|
| Rate for Payer: MEDICARE Medicare |
$232.40
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$315.40
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$322.04
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$315.40
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$315.40
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$282.20
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$265.60
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$265.60
|
|
|
ST EVAL SPEECH SOUND PRODUCTION
|
Facility
IP
|
$332.00
|
|
|
Service Code
|
CPT 92522 GN
|
| Hospital Charge Code |
20221105
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$232.40 |
| Max. Negotiated Rate |
$332.00 |
| Rate for Payer: AETNA Commercial |
$315.40
|
| Rate for Payer: AETNA Medicare |
$298.80
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$315.40
|
| Rate for Payer: BCBS Healthlink |
$298.80
|
| Rate for Payer: BCBS HMK CHIP |
$298.80
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$298.80
|
| Rate for Payer: BCBS POS |
$315.40
|
| Rate for Payer: BCBS Traditional |
$332.00
|
| Rate for Payer: CASH_PRICE |
$265.60
|
| Rate for Payer: CIGNA Commercial |
$315.40
|
| Rate for Payer: CIGNA Medicare |
$298.80
|
| Rate for Payer: HUMANA Commercial |
$298.80
|
| Rate for Payer: MEDICAID Medicaid |
$305.44
|
| Rate for Payer: MEDICARE Medicare |
$232.40
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$315.40
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$322.04
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$315.40
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$315.40
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$282.20
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$265.60
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$265.60
|
|
|
ST EVAL VOICE PROSTH/AUG COMM
|
Facility
IP
|
$363.00
|
|
|
Service Code
|
CPT 92597 GN
|
| Hospital Charge Code |
20221105
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$254.10 |
| Max. Negotiated Rate |
$363.00 |
| Rate for Payer: AETNA Commercial |
$344.85
|
| Rate for Payer: AETNA Medicare |
$326.70
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$344.85
|
| Rate for Payer: BCBS Healthlink |
$326.70
|
| Rate for Payer: BCBS HMK CHIP |
$326.70
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$326.70
|
| Rate for Payer: BCBS POS |
$344.85
|
| Rate for Payer: BCBS Traditional |
$363.00
|
| Rate for Payer: CASH_PRICE |
$290.40
|
| Rate for Payer: CIGNA Commercial |
$344.85
|
| Rate for Payer: CIGNA Medicare |
$326.70
|
| Rate for Payer: HUMANA Commercial |
$326.70
|
| Rate for Payer: MEDICAID Medicaid |
$333.96
|
| Rate for Payer: MEDICARE Medicare |
$254.10
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$344.85
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$352.11
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$344.85
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$344.85
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$308.55
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$290.40
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$290.40
|
|
|
ST EVAL VOICE PROSTH/AUG COMM
|
Facility
OP
|
$363.00
|
|
|
Service Code
|
CPT 92597 GN
|
| Hospital Charge Code |
20221105
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$254.10 |
| Max. Negotiated Rate |
$363.00 |
| Rate for Payer: AETNA Commercial |
$344.85
|
| Rate for Payer: AETNA Medicare |
$326.70
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$344.85
|
| Rate for Payer: BCBS Healthlink |
$326.70
|
| Rate for Payer: BCBS HMK CHIP |
$326.70
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$326.70
|
| Rate for Payer: BCBS POS |
$344.85
|
| Rate for Payer: BCBS Traditional |
$363.00
|
| Rate for Payer: CASH_PRICE |
$290.40
|
| Rate for Payer: CIGNA Commercial |
$344.85
|
| Rate for Payer: CIGNA Medicare |
$326.70
|
| Rate for Payer: HUMANA Commercial |
$326.70
|
| Rate for Payer: MEDICAID Medicaid |
$333.96
|
| Rate for Payer: MEDICARE Medicare |
$254.10
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$344.85
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$352.11
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$344.85
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$344.85
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$308.55
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$290.40
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$290.40
|
|
|
ST GROUP THERAPEUTIC PROC
|
Facility
OP
|
$90.00
|
|
|
Service Code
|
CPT 97150 GN
|
| Hospital Charge Code |
20221105
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$63.00 |
| Max. Negotiated Rate |
$90.00 |
| Rate for Payer: AETNA Commercial |
$85.50
|
| Rate for Payer: AETNA Medicare |
$81.00
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$85.50
|
| Rate for Payer: BCBS Healthlink |
$81.00
|
| Rate for Payer: BCBS HMK CHIP |
$81.00
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$81.00
|
| Rate for Payer: BCBS POS |
$85.50
|
| Rate for Payer: BCBS Traditional |
$90.00
|
| Rate for Payer: CASH_PRICE |
$72.00
|
| Rate for Payer: CIGNA Commercial |
$85.50
|
| Rate for Payer: CIGNA Medicare |
$81.00
|
| Rate for Payer: HUMANA Commercial |
$81.00
|
| Rate for Payer: MEDICAID Medicaid |
$82.80
|
| Rate for Payer: MEDICARE Medicare |
$63.00
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$85.50
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$87.30
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$85.50
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$85.50
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$76.50
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$72.00
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$72.00
|
|
|
ST GROUP THERAPEUTIC PROC
|
Facility
IP
|
$90.00
|
|
|
Service Code
|
CPT 97150 GN
|
| Hospital Charge Code |
20221105
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$63.00 |
| Max. Negotiated Rate |
$90.00 |
| Rate for Payer: AETNA Commercial |
$85.50
|
| Rate for Payer: AETNA Medicare |
$81.00
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$85.50
|
| Rate for Payer: BCBS Healthlink |
$81.00
|
| Rate for Payer: BCBS HMK CHIP |
$81.00
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$81.00
|
| Rate for Payer: BCBS POS |
$85.50
|
| Rate for Payer: BCBS Traditional |
$90.00
|
| Rate for Payer: CASH_PRICE |
$72.00
|
| Rate for Payer: CIGNA Commercial |
$85.50
|
| Rate for Payer: CIGNA Medicare |
$81.00
|
| Rate for Payer: HUMANA Commercial |
$81.00
|
| Rate for Payer: MEDICAID Medicaid |
$82.80
|
| Rate for Payer: MEDICARE Medicare |
$63.00
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$85.50
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$87.30
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$85.50
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$85.50
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$76.50
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$72.00
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$72.00
|
|
|
ST NEUROMUSCULAR RE-ED
|
Facility
IP
|
$106.00
|
|
|
Service Code
|
CPT 97112 GN
|
| Hospital Charge Code |
20221105
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$74.20 |
| Max. Negotiated Rate |
$106.00 |
| Rate for Payer: AETNA Commercial |
$100.70
|
| Rate for Payer: AETNA Medicare |
$95.40
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$100.70
|
| Rate for Payer: BCBS Healthlink |
$95.40
|
| Rate for Payer: BCBS HMK CHIP |
$95.40
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$95.40
|
| Rate for Payer: BCBS POS |
$100.70
|
| Rate for Payer: BCBS Traditional |
$106.00
|
| Rate for Payer: CASH_PRICE |
$84.80
|
| Rate for Payer: CIGNA Commercial |
$100.70
|
| Rate for Payer: CIGNA Medicare |
$95.40
|
| Rate for Payer: HUMANA Commercial |
$95.40
|
| Rate for Payer: MEDICAID Medicaid |
$97.52
|
| Rate for Payer: MEDICARE Medicare |
$74.20
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$100.70
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$102.82
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$100.70
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$100.70
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$90.10
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$84.80
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$84.80
|
|
|
ST NEUROMUSCULAR RE-ED
|
Facility
OP
|
$106.00
|
|
|
Service Code
|
CPT 97112 GN
|
| Hospital Charge Code |
20221105
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$74.20 |
| Max. Negotiated Rate |
$106.00 |
| Rate for Payer: AETNA Commercial |
$100.70
|
| Rate for Payer: AETNA Medicare |
$95.40
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$100.70
|
| Rate for Payer: BCBS Healthlink |
$95.40
|
| Rate for Payer: BCBS HMK CHIP |
$95.40
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$95.40
|
| Rate for Payer: BCBS POS |
$100.70
|
| Rate for Payer: BCBS Traditional |
$106.00
|
| Rate for Payer: CASH_PRICE |
$84.80
|
| Rate for Payer: CIGNA Commercial |
$100.70
|
| Rate for Payer: CIGNA Medicare |
$95.40
|
| Rate for Payer: HUMANA Commercial |
$95.40
|
| Rate for Payer: MEDICAID Medicaid |
$97.52
|
| Rate for Payer: MEDICARE Medicare |
$74.20
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$100.70
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$102.82
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$100.70
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$100.70
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$90.10
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$84.80
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$84.80
|
|
|
ST OFC/OUT-PT FOR EVAL/MGMT
|
Facility
IP
|
$159.00
|
|
|
Service Code
|
CPT 99202 GN
|
| Hospital Charge Code |
20221105
|
|
Hospital Revenue Code
|
979
|
| Min. Negotiated Rate |
$111.30 |
| Max. Negotiated Rate |
$159.00 |
| Rate for Payer: AETNA Commercial |
$151.05
|
| Rate for Payer: AETNA Medicare |
$143.10
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$151.05
|
| Rate for Payer: BCBS Healthlink |
$143.10
|
| Rate for Payer: BCBS HMK CHIP |
$143.10
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$143.10
|
| Rate for Payer: BCBS POS |
$151.05
|
| Rate for Payer: BCBS Traditional |
$159.00
|
| Rate for Payer: CASH_PRICE |
$127.20
|
| Rate for Payer: CIGNA Commercial |
$151.05
|
| Rate for Payer: CIGNA Medicare |
$143.10
|
| Rate for Payer: HUMANA Commercial |
$143.10
|
| Rate for Payer: MEDICAID Medicaid |
$146.28
|
| Rate for Payer: MEDICARE Medicare |
$111.30
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$151.05
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$154.23
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$151.05
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$151.05
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$135.15
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$127.20
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$127.20
|
|
|
ST OFC/OUT-PT FOR EVAL/MGMT
|
Facility
OP
|
$159.00
|
|
|
Service Code
|
CPT 99202 GN
|
| Hospital Charge Code |
20221105
|
|
Hospital Revenue Code
|
979
|
| Min. Negotiated Rate |
$111.30 |
| Max. Negotiated Rate |
$159.00 |
| Rate for Payer: AETNA Commercial |
$151.05
|
| Rate for Payer: AETNA Medicare |
$143.10
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$151.05
|
| Rate for Payer: BCBS Healthlink |
$143.10
|
| Rate for Payer: BCBS HMK CHIP |
$143.10
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$143.10
|
| Rate for Payer: BCBS POS |
$151.05
|
| Rate for Payer: BCBS Traditional |
$159.00
|
| Rate for Payer: CASH_PRICE |
$127.20
|
| Rate for Payer: CIGNA Commercial |
$151.05
|
| Rate for Payer: CIGNA Medicare |
$143.10
|
| Rate for Payer: HUMANA Commercial |
$143.10
|
| Rate for Payer: MEDICAID Medicaid |
$146.28
|
| Rate for Payer: MEDICARE Medicare |
$111.30
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$151.05
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$154.23
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$151.05
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$151.05
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$135.15
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$127.20
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$127.20
|
|
|
ST OFC/OUT-PT (MINOR 5MIN)
|
Facility
IP
|
$89.00
|
|
|
Service Code
|
CPT 99211 GN
|
| Hospital Charge Code |
20221105
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$62.30 |
| Max. Negotiated Rate |
$89.00 |
| Rate for Payer: AETNA Commercial |
$84.55
|
| Rate for Payer: AETNA Medicare |
$80.10
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$84.55
|
| Rate for Payer: BCBS Healthlink |
$80.10
|
| Rate for Payer: BCBS HMK CHIP |
$80.10
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$80.10
|
| Rate for Payer: BCBS POS |
$84.55
|
| Rate for Payer: BCBS Traditional |
$89.00
|
| Rate for Payer: CASH_PRICE |
$71.20
|
| Rate for Payer: CIGNA Commercial |
$84.55
|
| Rate for Payer: CIGNA Medicare |
$80.10
|
| Rate for Payer: HUMANA Commercial |
$80.10
|
| Rate for Payer: MEDICAID Medicaid |
$81.88
|
| Rate for Payer: MEDICARE Medicare |
$62.30
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$84.55
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$86.33
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$84.55
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$84.55
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$75.65
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$71.20
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$71.20
|
|
|
ST OFC/OUT-PT (MINOR 5MIN)
|
Facility
OP
|
$89.00
|
|
|
Service Code
|
CPT 99211 GN
|
| Hospital Charge Code |
20221105
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$62.30 |
| Max. Negotiated Rate |
$89.00 |
| Rate for Payer: AETNA Commercial |
$84.55
|
| Rate for Payer: AETNA Medicare |
$80.10
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$84.55
|
| Rate for Payer: BCBS Healthlink |
$80.10
|
| Rate for Payer: BCBS HMK CHIP |
$80.10
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$80.10
|
| Rate for Payer: BCBS POS |
$84.55
|
| Rate for Payer: BCBS Traditional |
$89.00
|
| Rate for Payer: CASH_PRICE |
$71.20
|
| Rate for Payer: CIGNA Commercial |
$84.55
|
| Rate for Payer: CIGNA Medicare |
$80.10
|
| Rate for Payer: HUMANA Commercial |
$80.10
|
| Rate for Payer: MEDICAID Medicaid |
$81.88
|
| Rate for Payer: MEDICARE Medicare |
$62.30
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$84.55
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$86.33
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$84.55
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$84.55
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$75.65
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$71.20
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$71.20
|
|
|
ST OFC/OUT-PT OF EST PT(2/3 COMP 10MIN)
|
Facility
OP
|
$169.00
|
|
|
Service Code
|
CPT 99212 GN
|
| Hospital Charge Code |
20221105
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$118.30 |
| Max. Negotiated Rate |
$169.00 |
| Rate for Payer: AETNA Commercial |
$160.55
|
| Rate for Payer: AETNA Medicare |
$152.10
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$160.55
|
| Rate for Payer: BCBS Healthlink |
$152.10
|
| Rate for Payer: BCBS HMK CHIP |
$152.10
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$152.10
|
| Rate for Payer: BCBS POS |
$160.55
|
| Rate for Payer: BCBS Traditional |
$169.00
|
| Rate for Payer: CASH_PRICE |
$135.20
|
| Rate for Payer: CIGNA Commercial |
$160.55
|
| Rate for Payer: CIGNA Medicare |
$152.10
|
| Rate for Payer: HUMANA Commercial |
$152.10
|
| Rate for Payer: MEDICAID Medicaid |
$155.48
|
| Rate for Payer: MEDICARE Medicare |
$118.30
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$160.55
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$163.93
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$160.55
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$160.55
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$143.65
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$135.20
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$135.20
|
|
|
ST OFC/OUT-PT OF EST PT(2/3 COMP 10MIN)
|
Facility
IP
|
$169.00
|
|
|
Service Code
|
CPT 99212 GN
|
| Hospital Charge Code |
20221105
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$118.30 |
| Max. Negotiated Rate |
$169.00 |
| Rate for Payer: AETNA Commercial |
$160.55
|
| Rate for Payer: AETNA Medicare |
$152.10
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$160.55
|
| Rate for Payer: BCBS Healthlink |
$152.10
|
| Rate for Payer: BCBS HMK CHIP |
$152.10
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$152.10
|
| Rate for Payer: BCBS POS |
$160.55
|
| Rate for Payer: BCBS Traditional |
$169.00
|
| Rate for Payer: CASH_PRICE |
$135.20
|
| Rate for Payer: CIGNA Commercial |
$160.55
|
| Rate for Payer: CIGNA Medicare |
$152.10
|
| Rate for Payer: HUMANA Commercial |
$152.10
|
| Rate for Payer: MEDICAID Medicaid |
$155.48
|
| Rate for Payer: MEDICARE Medicare |
$118.30
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$160.55
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$163.93
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$160.55
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$160.55
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$143.65
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$135.20
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$135.20
|
|
|
ST OFC/OUT-PT OF NEW PT
|
Facility
IP
|
$99.00
|
|
|
Service Code
|
CPT 99201 GN
|
| Hospital Charge Code |
20221105
|
|
Hospital Revenue Code
|
440
|
| 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
|
|
|
ST OFC/OUT-PT OF NEW PT
|
Facility
OP
|
$99.00
|
|
|
Service Code
|
CPT 99201 GN
|
| Hospital Charge Code |
20221105
|
|
Hospital Revenue Code
|
440
|
| 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
|
|
|
.STOOL CULTURE, ADDITIONAL PATHOGENS
|
Facility
IP
|
$21.00
|
|
|
Service Code
|
CPT 87046
|
| Hospital Charge Code |
20221105
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$14.70 |
| Max. Negotiated Rate |
$21.00 |
| Rate for Payer: BCBS HMK CHIP |
$18.90
|
| Rate for Payer: AETNA Commercial |
$19.95
|
| Rate for Payer: AETNA Medicare |
$18.90
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$19.95
|
| Rate for Payer: BCBS Healthlink |
$18.90
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$18.90
|
| Rate for Payer: BCBS POS |
$19.95
|
| Rate for Payer: BCBS Traditional |
$21.00
|
| Rate for Payer: CASH_PRICE |
$16.80
|
| Rate for Payer: CIGNA Commercial |
$19.95
|
| Rate for Payer: CIGNA Medicare |
$18.90
|
| Rate for Payer: HUMANA Commercial |
$18.90
|
| Rate for Payer: MEDICAID Medicaid |
$19.32
|
| Rate for Payer: MEDICARE Medicare |
$14.70
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$19.95
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$20.37
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$19.95
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$19.95
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$17.85
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$16.80
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$16.80
|
|
|
.STOOL CULTURE, ADDITIONAL PATHOGENS
|
Facility
OP
|
$21.00
|
|
|
Service Code
|
CPT 87046
|
| Hospital Charge Code |
20221105
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$14.70 |
| Max. Negotiated Rate |
$21.00 |
| Rate for Payer: AETNA Commercial |
$19.95
|
| Rate for Payer: AETNA Medicare |
$18.90
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$19.95
|
| Rate for Payer: BCBS Healthlink |
$18.90
|
| Rate for Payer: BCBS HMK CHIP |
$18.90
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$18.90
|
| Rate for Payer: BCBS POS |
$19.95
|
| Rate for Payer: BCBS Traditional |
$21.00
|
| Rate for Payer: CASH_PRICE |
$16.80
|
| Rate for Payer: CIGNA Commercial |
$19.95
|
| Rate for Payer: CIGNA Medicare |
$18.90
|
| Rate for Payer: HUMANA Commercial |
$18.90
|
| Rate for Payer: MEDICAID Medicaid |
$19.32
|
| Rate for Payer: MEDICARE Medicare |
$14.70
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$19.95
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$20.37
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$19.95
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$19.95
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$17.85
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$16.80
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$16.80
|
|
|
.STOOL CULTURE AEROBIC, SALM/SHIG
|
Facility
IP
|
$42.00
|
|
|
Service Code
|
CPT 87045
|
| Hospital Charge Code |
20221105
|
|
Hospital Revenue Code
|
300
|
| 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
|
|
|
.STOOL CULTURE AEROBIC, SALM/SHIG
|
Facility
OP
|
$42.00
|
|
|
Service Code
|
CPT 87045
|
| Hospital Charge Code |
20221105
|
|
Hospital Revenue Code
|
300
|
| 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
|
|
|
STRAPPNG OF THE KNEE
|
Facility
IP
|
$208.00
|
|
|
Service Code
|
CPT 29530
|
| 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
|
|
|
STRAPPNG OF THE KNEE
|
Facility
OP
|
$208.00
|
|
|
Service Code
|
CPT 29530
|
| 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
|
|
|
STRETCH BANDAGE 2''
|
Facility
IP
|
$4.00
|
|
| Hospital Charge Code |
20221105
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$2.80 |
| Max. Negotiated Rate |
$4.00 |
| Rate for Payer: AETNA Commercial |
$3.80
|
| Rate for Payer: AETNA Medicare |
$3.60
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$3.80
|
| Rate for Payer: BCBS Healthlink |
$3.60
|
| Rate for Payer: BCBS HMK CHIP |
$3.60
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$3.60
|
| Rate for Payer: BCBS POS |
$3.80
|
| Rate for Payer: BCBS Traditional |
$4.00
|
| Rate for Payer: CASH_PRICE |
$3.20
|
| Rate for Payer: CIGNA Commercial |
$3.80
|
| Rate for Payer: CIGNA Medicare |
$3.60
|
| Rate for Payer: HUMANA Commercial |
$3.60
|
| Rate for Payer: MEDICAID Medicaid |
$3.68
|
| Rate for Payer: MEDICARE Medicare |
$2.80
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$3.80
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$3.88
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$3.80
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$3.80
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$3.40
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$3.20
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$3.20
|
|
|
STRETCH BANDAGE 2''
|
Facility
OP
|
$4.00
|
|
| Hospital Charge Code |
20221105
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$2.80 |
| Max. Negotiated Rate |
$4.00 |
| Rate for Payer: AETNA Commercial |
$3.80
|
| Rate for Payer: AETNA Medicare |
$3.60
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$3.80
|
| Rate for Payer: BCBS Healthlink |
$3.60
|
| Rate for Payer: BCBS HMK CHIP |
$3.60
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$3.60
|
| Rate for Payer: BCBS POS |
$3.80
|
| Rate for Payer: BCBS Traditional |
$4.00
|
| Rate for Payer: CASH_PRICE |
$3.20
|
| Rate for Payer: CIGNA Commercial |
$3.80
|
| Rate for Payer: CIGNA Medicare |
$3.60
|
| Rate for Payer: HUMANA Commercial |
$3.60
|
| Rate for Payer: MEDICAID Medicaid |
$3.68
|
| Rate for Payer: MEDICARE Medicare |
$2.80
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$3.80
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$3.88
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$3.80
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$3.80
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$3.40
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$3.20
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$3.20
|
|
|
STRETCH BANDAGE 2'' STERILE
|
Facility
IP
|
$11.00
|
|
| Hospital Charge Code |
20221105
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$7.70 |
| Max. Negotiated Rate |
$11.00 |
| Rate for Payer: AETNA Commercial |
$10.45
|
| Rate for Payer: AETNA Medicare |
$9.90
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$10.45
|
| Rate for Payer: BCBS Healthlink |
$9.90
|
| Rate for Payer: BCBS HMK CHIP |
$9.90
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$9.90
|
| Rate for Payer: BCBS POS |
$10.45
|
| Rate for Payer: BCBS Traditional |
$11.00
|
| Rate for Payer: CASH_PRICE |
$8.80
|
| Rate for Payer: CIGNA Commercial |
$10.45
|
| Rate for Payer: CIGNA Medicare |
$9.90
|
| Rate for Payer: HUMANA Commercial |
$9.90
|
| Rate for Payer: MEDICAID Medicaid |
$10.12
|
| Rate for Payer: MEDICARE Medicare |
$7.70
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$10.45
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$10.67
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$10.45
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$10.45
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$9.35
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$8.80
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$8.80
|
|
