|
TR EXCISION MALIGNANT LESION INC MARGINS
|
Facility
OP
|
$530.00
|
|
|
Service Code
|
CPT 11602
|
| Hospital Charge Code |
20221105
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$371.00 |
| Max. Negotiated Rate |
$530.00 |
| Rate for Payer: AETNA Commercial |
$503.50
|
| Rate for Payer: AETNA Medicare |
$477.00
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$503.50
|
| Rate for Payer: BCBS Healthlink |
$477.00
|
| Rate for Payer: BCBS HMK CHIP |
$477.00
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$477.00
|
| Rate for Payer: BCBS POS |
$503.50
|
| Rate for Payer: BCBS Traditional |
$530.00
|
| Rate for Payer: CASH_PRICE |
$424.00
|
| Rate for Payer: CIGNA Commercial |
$503.50
|
| Rate for Payer: CIGNA Medicare |
$477.00
|
| Rate for Payer: HUMANA Commercial |
$477.00
|
| Rate for Payer: MEDICAID Medicaid |
$487.60
|
| Rate for Payer: MEDICARE Medicare |
$371.00
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$503.50
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$514.10
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$503.50
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$503.50
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$450.50
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$424.00
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$424.00
|
|
|
TR EXCISION MALIGNANT LESION INC MARGINS
|
Facility
IP
|
$530.00
|
|
|
Service Code
|
CPT 11602
|
| Hospital Charge Code |
20221105
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$371.00 |
| Max. Negotiated Rate |
$530.00 |
| Rate for Payer: AETNA Commercial |
$503.50
|
| Rate for Payer: AETNA Medicare |
$477.00
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$503.50
|
| Rate for Payer: BCBS Healthlink |
$477.00
|
| Rate for Payer: BCBS HMK CHIP |
$477.00
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$477.00
|
| Rate for Payer: BCBS POS |
$503.50
|
| Rate for Payer: BCBS Traditional |
$530.00
|
| Rate for Payer: CASH_PRICE |
$424.00
|
| Rate for Payer: CIGNA Commercial |
$503.50
|
| Rate for Payer: CIGNA Medicare |
$477.00
|
| Rate for Payer: HUMANA Commercial |
$477.00
|
| Rate for Payer: MEDICAID Medicaid |
$487.60
|
| Rate for Payer: MEDICARE Medicare |
$371.00
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$503.50
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$514.10
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$503.50
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$503.50
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$450.50
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$424.00
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$424.00
|
|
|
TR GI SERVICES GENERAL
|
Facility
OP
|
$2,358.00
|
|
|
Service Code
|
CPT 43246
|
| Hospital Charge Code |
20221105
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,650.60 |
| Max. Negotiated Rate |
$2,358.00 |
| Rate for Payer: AETNA Commercial |
$2,240.10
|
| Rate for Payer: AETNA Medicare |
$2,122.20
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$2,240.10
|
| Rate for Payer: BCBS Healthlink |
$2,122.20
|
| Rate for Payer: BCBS HMK CHIP |
$2,122.20
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$2,122.20
|
| Rate for Payer: BCBS POS |
$2,240.10
|
| Rate for Payer: BCBS Traditional |
$2,358.00
|
| Rate for Payer: CASH_PRICE |
$1,886.40
|
| Rate for Payer: CIGNA Commercial |
$2,240.10
|
| Rate for Payer: CIGNA Medicare |
$2,122.20
|
| Rate for Payer: HUMANA Commercial |
$2,122.20
|
| Rate for Payer: MEDICAID Medicaid |
$2,169.36
|
| Rate for Payer: MEDICARE Medicare |
$1,650.60
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$2,240.10
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$2,287.26
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$2,240.10
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$2,240.10
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$2,004.30
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$1,886.40
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$1,886.40
|
|
|
TR GI SERVICES GENERAL
|
Facility
IP
|
$2,358.00
|
|
|
Service Code
|
CPT 43246
|
| Hospital Charge Code |
20221105
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,650.60 |
| Max. Negotiated Rate |
$2,358.00 |
| Rate for Payer: AETNA Commercial |
$2,240.10
|
| Rate for Payer: AETNA Medicare |
$2,122.20
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$2,240.10
|
| Rate for Payer: BCBS Healthlink |
$2,122.20
|
| Rate for Payer: BCBS HMK CHIP |
$2,122.20
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$2,122.20
|
| Rate for Payer: BCBS POS |
$2,240.10
|
| Rate for Payer: BCBS Traditional |
$2,358.00
|
| Rate for Payer: CASH_PRICE |
$1,886.40
|
| Rate for Payer: CIGNA Commercial |
$2,240.10
|
| Rate for Payer: CIGNA Medicare |
$2,122.20
|
| Rate for Payer: HUMANA Commercial |
$2,122.20
|
| Rate for Payer: MEDICAID Medicaid |
$2,169.36
|
| Rate for Payer: MEDICARE Medicare |
$1,650.60
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$2,240.10
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$2,287.26
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$2,240.10
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$2,240.10
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$2,004.30
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$1,886.40
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$1,886.40
|
|
|
TRIAMCINOLONE 0.1% CREAM [15 GM]
|
Facility
OP
|
$13.00
|
|
|
Service Code
|
CPT J3490
|
| Hospital Charge Code |
20221105
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$9.10 |
| Max. Negotiated Rate |
$13.00 |
| Rate for Payer: AETNA Commercial |
$12.35
|
| Rate for Payer: AETNA Medicare |
$11.70
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$12.35
|
| Rate for Payer: BCBS Healthlink |
$11.70
|
| Rate for Payer: BCBS HMK CHIP |
$11.70
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$11.70
|
| Rate for Payer: BCBS POS |
$12.35
|
| Rate for Payer: BCBS Traditional |
$13.00
|
| Rate for Payer: CASH_PRICE |
$10.40
|
| Rate for Payer: CIGNA Commercial |
$12.35
|
| Rate for Payer: CIGNA Medicare |
$11.70
|
| Rate for Payer: HUMANA Commercial |
$11.70
|
| Rate for Payer: MEDICAID Medicaid |
$11.96
|
| Rate for Payer: MEDICARE Medicare |
$9.10
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$12.35
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$12.61
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$12.35
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$12.35
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$11.05
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$10.40
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$10.40
|
|
|
TRIAMCINOLONE 0.1% CREAM [15 GM]
|
Facility
IP
|
$13.00
|
|
|
Service Code
|
CPT J3490
|
| Hospital Charge Code |
20221105
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$9.10 |
| Max. Negotiated Rate |
$13.00 |
| Rate for Payer: AETNA Commercial |
$12.35
|
| Rate for Payer: AETNA Medicare |
$11.70
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$12.35
|
| Rate for Payer: BCBS Healthlink |
$11.70
|
| Rate for Payer: BCBS HMK CHIP |
$11.70
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$11.70
|
| Rate for Payer: BCBS POS |
$12.35
|
| Rate for Payer: BCBS Traditional |
$13.00
|
| Rate for Payer: CASH_PRICE |
$10.40
|
| Rate for Payer: CIGNA Commercial |
$12.35
|
| Rate for Payer: CIGNA Medicare |
$11.70
|
| Rate for Payer: HUMANA Commercial |
$11.70
|
| Rate for Payer: MEDICAID Medicaid |
$11.96
|
| Rate for Payer: MEDICARE Medicare |
$9.10
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$12.35
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$12.61
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$12.35
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$12.35
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$11.05
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$10.40
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$10.40
|
|
|
TRIAMCINOLONE INJ [40 MG/ML]
|
Facility
IP
|
$35.00
|
|
|
Service Code
|
CPT J3301
|
| Hospital Charge Code |
20221105
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$24.50 |
| Max. Negotiated Rate |
$35.00 |
| Rate for Payer: AETNA Commercial |
$33.25
|
| Rate for Payer: AETNA Medicare |
$31.50
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$33.25
|
| Rate for Payer: BCBS Healthlink |
$31.50
|
| Rate for Payer: BCBS HMK CHIP |
$31.50
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$31.50
|
| Rate for Payer: BCBS POS |
$33.25
|
| Rate for Payer: BCBS Traditional |
$35.00
|
| Rate for Payer: CASH_PRICE |
$28.00
|
| Rate for Payer: CIGNA Commercial |
$33.25
|
| Rate for Payer: CIGNA Medicare |
$31.50
|
| Rate for Payer: HUMANA Commercial |
$31.50
|
| Rate for Payer: MEDICAID Medicaid |
$32.20
|
| Rate for Payer: MEDICARE Medicare |
$24.50
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$33.25
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$33.95
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$33.25
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$33.25
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$29.75
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$28.00
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$28.00
|
|
|
TRIAMCINOLONE INJ [40 MG/ML]
|
Facility
OP
|
$35.00
|
|
|
Service Code
|
CPT J3301
|
| Hospital Charge Code |
20221105
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$24.50 |
| Max. Negotiated Rate |
$35.00 |
| Rate for Payer: AETNA Commercial |
$33.25
|
| Rate for Payer: AETNA Medicare |
$31.50
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$33.25
|
| Rate for Payer: BCBS Healthlink |
$31.50
|
| Rate for Payer: BCBS HMK CHIP |
$31.50
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$31.50
|
| Rate for Payer: BCBS POS |
$33.25
|
| Rate for Payer: BCBS Traditional |
$35.00
|
| Rate for Payer: CASH_PRICE |
$28.00
|
| Rate for Payer: CIGNA Commercial |
$33.25
|
| Rate for Payer: CIGNA Medicare |
$31.50
|
| Rate for Payer: HUMANA Commercial |
$31.50
|
| Rate for Payer: MEDICAID Medicaid |
$32.20
|
| Rate for Payer: MEDICARE Medicare |
$24.50
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$33.25
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$33.95
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$33.25
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$33.25
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$29.75
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$28.00
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$28.00
|
|
|
TRIAMTER/ HCTZ CAP [37.5-25 MG]
|
Facility
OP
|
$8.00
|
|
|
Service Code
|
CPT J3490
|
| Hospital Charge Code |
20220524
|
|
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
|
|
|
TRIAMTER/ HCTZ CAP [37.5-25 MG]
|
Facility
IP
|
$8.00
|
|
|
Service Code
|
CPT J3490
|
| Hospital Charge Code |
20220524
|
|
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
|
|
|
TRICHOMONAS
|
Facility
OP
|
$139.00
|
|
|
Service Code
|
CPT 87661
|
| Hospital Charge Code |
20221105
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$97.30 |
| Max. Negotiated Rate |
$139.00 |
| Rate for Payer: AETNA Commercial |
$132.05
|
| Rate for Payer: AETNA Medicare |
$125.10
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$132.05
|
| Rate for Payer: BCBS Healthlink |
$125.10
|
| Rate for Payer: BCBS HMK CHIP |
$125.10
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$125.10
|
| Rate for Payer: BCBS POS |
$132.05
|
| Rate for Payer: BCBS Traditional |
$139.00
|
| Rate for Payer: CASH_PRICE |
$111.20
|
| Rate for Payer: CIGNA Commercial |
$132.05
|
| Rate for Payer: CIGNA Medicare |
$125.10
|
| Rate for Payer: HUMANA Commercial |
$125.10
|
| Rate for Payer: MEDICAID Medicaid |
$127.88
|
| Rate for Payer: MEDICARE Medicare |
$97.30
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$132.05
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$134.83
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$132.05
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$132.05
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$118.15
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$111.20
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$111.20
|
|
|
TRICHOMONAS
|
Facility
IP
|
$139.00
|
|
|
Service Code
|
CPT 87661
|
| Hospital Charge Code |
20221105
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$97.30 |
| Max. Negotiated Rate |
$139.00 |
| Rate for Payer: AETNA Commercial |
$132.05
|
| Rate for Payer: AETNA Medicare |
$125.10
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$132.05
|
| Rate for Payer: BCBS Healthlink |
$125.10
|
| Rate for Payer: BCBS HMK CHIP |
$125.10
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$125.10
|
| Rate for Payer: BCBS POS |
$132.05
|
| Rate for Payer: BCBS Traditional |
$139.00
|
| Rate for Payer: CASH_PRICE |
$111.20
|
| Rate for Payer: CIGNA Commercial |
$132.05
|
| Rate for Payer: CIGNA Medicare |
$125.10
|
| Rate for Payer: HUMANA Commercial |
$125.10
|
| Rate for Payer: MEDICAID Medicaid |
$127.88
|
| Rate for Payer: MEDICARE Medicare |
$97.30
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$132.05
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$134.83
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$132.05
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$132.05
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$118.15
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$111.20
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$111.20
|
|
|
TR I & D PILONIDAL CYST SIMPLE
|
Facility
OP
|
$354.00
|
|
|
Service Code
|
CPT 10080
|
| Hospital Charge Code |
20221105
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$247.80 |
| Max. Negotiated Rate |
$354.00 |
| Rate for Payer: AETNA Commercial |
$336.30
|
| Rate for Payer: AETNA Medicare |
$318.60
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$336.30
|
| Rate for Payer: BCBS Healthlink |
$318.60
|
| Rate for Payer: BCBS HMK CHIP |
$318.60
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$318.60
|
| Rate for Payer: BCBS POS |
$336.30
|
| Rate for Payer: BCBS Traditional |
$354.00
|
| Rate for Payer: CASH_PRICE |
$283.20
|
| Rate for Payer: CIGNA Commercial |
$336.30
|
| Rate for Payer: CIGNA Medicare |
$318.60
|
| Rate for Payer: HUMANA Commercial |
$318.60
|
| Rate for Payer: MEDICAID Medicaid |
$325.68
|
| Rate for Payer: MEDICARE Medicare |
$247.80
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$336.30
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$343.38
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$336.30
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$336.30
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$300.90
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$283.20
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$283.20
|
|
|
TR I & D PILONIDAL CYST SIMPLE
|
Facility
IP
|
$354.00
|
|
|
Service Code
|
CPT 10080
|
| Hospital Charge Code |
20221105
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$247.80 |
| Max. Negotiated Rate |
$354.00 |
| Rate for Payer: AETNA Commercial |
$336.30
|
| Rate for Payer: AETNA Medicare |
$318.60
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$336.30
|
| Rate for Payer: BCBS Healthlink |
$318.60
|
| Rate for Payer: BCBS HMK CHIP |
$318.60
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$318.60
|
| Rate for Payer: BCBS POS |
$336.30
|
| Rate for Payer: BCBS Traditional |
$354.00
|
| Rate for Payer: CASH_PRICE |
$283.20
|
| Rate for Payer: CIGNA Commercial |
$336.30
|
| Rate for Payer: CIGNA Medicare |
$318.60
|
| Rate for Payer: HUMANA Commercial |
$318.60
|
| Rate for Payer: MEDICAID Medicaid |
$325.68
|
| Rate for Payer: MEDICARE Medicare |
$247.80
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$336.30
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$343.38
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$336.30
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$336.30
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$300.90
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$283.20
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$283.20
|
|
|
TRIGGER POINT INJ 1-2 MUSCLES
|
Facility
OP
|
$328.00
|
|
|
Service Code
|
CPT 20552
|
| Hospital Charge Code |
20221105
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$229.60 |
| Max. Negotiated Rate |
$328.00 |
| Rate for Payer: AETNA Commercial |
$311.60
|
| Rate for Payer: AETNA Medicare |
$295.20
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$311.60
|
| Rate for Payer: BCBS Healthlink |
$295.20
|
| Rate for Payer: BCBS HMK CHIP |
$295.20
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$295.20
|
| Rate for Payer: BCBS POS |
$311.60
|
| Rate for Payer: BCBS Traditional |
$328.00
|
| Rate for Payer: CASH_PRICE |
$262.40
|
| Rate for Payer: CIGNA Commercial |
$311.60
|
| Rate for Payer: CIGNA Medicare |
$295.20
|
| Rate for Payer: HUMANA Commercial |
$295.20
|
| Rate for Payer: MEDICAID Medicaid |
$301.76
|
| Rate for Payer: MEDICARE Medicare |
$229.60
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$311.60
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$318.16
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$311.60
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$311.60
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$278.80
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$262.40
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$262.40
|
|
|
TRIGGER POINT INJ 1-2 MUSCLES
|
Facility
IP
|
$328.00
|
|
|
Service Code
|
CPT 20552
|
| Hospital Charge Code |
20221105
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$229.60 |
| Max. Negotiated Rate |
$328.00 |
| Rate for Payer: AETNA Commercial |
$311.60
|
| Rate for Payer: AETNA Medicare |
$295.20
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$311.60
|
| Rate for Payer: BCBS Healthlink |
$295.20
|
| Rate for Payer: BCBS HMK CHIP |
$295.20
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$295.20
|
| Rate for Payer: BCBS POS |
$311.60
|
| Rate for Payer: BCBS Traditional |
$328.00
|
| Rate for Payer: CASH_PRICE |
$262.40
|
| Rate for Payer: CIGNA Commercial |
$311.60
|
| Rate for Payer: CIGNA Medicare |
$295.20
|
| Rate for Payer: HUMANA Commercial |
$295.20
|
| Rate for Payer: MEDICAID Medicaid |
$301.76
|
| Rate for Payer: MEDICARE Medicare |
$229.60
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$311.60
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$318.16
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$311.60
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$311.60
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$278.80
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$262.40
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$262.40
|
|
|
TRIGLYCERIDES
|
Facility
IP
|
$76.00
|
|
|
Service Code
|
CPT 84478
|
| Hospital Charge Code |
20221105
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$53.20 |
| Max. Negotiated Rate |
$76.00 |
| Rate for Payer: AETNA Commercial |
$72.20
|
| Rate for Payer: AETNA Medicare |
$68.40
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$72.20
|
| Rate for Payer: BCBS Healthlink |
$68.40
|
| Rate for Payer: BCBS HMK CHIP |
$68.40
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$68.40
|
| Rate for Payer: BCBS POS |
$72.20
|
| Rate for Payer: BCBS Traditional |
$76.00
|
| Rate for Payer: CASH_PRICE |
$60.80
|
| Rate for Payer: CIGNA Commercial |
$72.20
|
| Rate for Payer: CIGNA Medicare |
$68.40
|
| Rate for Payer: HUMANA Commercial |
$68.40
|
| Rate for Payer: MEDICAID Medicaid |
$69.92
|
| Rate for Payer: MEDICARE Medicare |
$53.20
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$72.20
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$73.72
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$72.20
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$72.20
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$64.60
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$60.80
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$60.80
|
|
|
TRIGLYCERIDES
|
Facility
OP
|
$76.00
|
|
|
Service Code
|
CPT 84478
|
| Hospital Charge Code |
20221105
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$53.20 |
| Max. Negotiated Rate |
$76.00 |
| Rate for Payer: AETNA Commercial |
$72.20
|
| Rate for Payer: AETNA Medicare |
$68.40
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$72.20
|
| Rate for Payer: BCBS Healthlink |
$68.40
|
| Rate for Payer: BCBS HMK CHIP |
$68.40
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$68.40
|
| Rate for Payer: BCBS POS |
$72.20
|
| Rate for Payer: BCBS Traditional |
$76.00
|
| Rate for Payer: CASH_PRICE |
$60.80
|
| Rate for Payer: CIGNA Commercial |
$72.20
|
| Rate for Payer: CIGNA Medicare |
$68.40
|
| Rate for Payer: HUMANA Commercial |
$68.40
|
| Rate for Payer: MEDICAID Medicaid |
$69.92
|
| Rate for Payer: MEDICARE Medicare |
$53.20
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$72.20
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$73.72
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$72.20
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$72.20
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$64.60
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$60.80
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$60.80
|
|
|
TRIMMING NONDYSTROPHIC NAILS ANY #
|
Facility
OP
|
$75.00
|
|
|
Service Code
|
CPT 11719
|
| Hospital Charge Code |
20221105
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$52.50 |
| Max. Negotiated Rate |
$75.00 |
| Rate for Payer: AETNA Commercial |
$71.25
|
| Rate for Payer: AETNA Medicare |
$67.50
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$71.25
|
| Rate for Payer: BCBS Healthlink |
$67.50
|
| Rate for Payer: BCBS HMK CHIP |
$67.50
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$67.50
|
| Rate for Payer: BCBS POS |
$71.25
|
| Rate for Payer: BCBS Traditional |
$75.00
|
| Rate for Payer: CASH_PRICE |
$60.00
|
| Rate for Payer: CIGNA Commercial |
$71.25
|
| Rate for Payer: CIGNA Medicare |
$67.50
|
| Rate for Payer: HUMANA Commercial |
$67.50
|
| Rate for Payer: MEDICAID Medicaid |
$69.00
|
| Rate for Payer: MEDICARE Medicare |
$52.50
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$71.25
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$72.75
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$71.25
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$71.25
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$63.75
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$60.00
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$60.00
|
|
|
TRIMMING NONDYSTROPHIC NAILS ANY #
|
Facility
IP
|
$75.00
|
|
|
Service Code
|
CPT 11719
|
| Hospital Charge Code |
20221105
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$52.50 |
| Max. Negotiated Rate |
$75.00 |
| Rate for Payer: AETNA Commercial |
$71.25
|
| Rate for Payer: AETNA Medicare |
$67.50
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$71.25
|
| Rate for Payer: BCBS Healthlink |
$67.50
|
| Rate for Payer: BCBS HMK CHIP |
$67.50
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$67.50
|
| Rate for Payer: BCBS POS |
$71.25
|
| Rate for Payer: BCBS Traditional |
$75.00
|
| Rate for Payer: CASH_PRICE |
$60.00
|
| Rate for Payer: CIGNA Commercial |
$71.25
|
| Rate for Payer: CIGNA Medicare |
$67.50
|
| Rate for Payer: HUMANA Commercial |
$67.50
|
| Rate for Payer: MEDICAID Medicaid |
$69.00
|
| Rate for Payer: MEDICARE Medicare |
$52.50
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$71.25
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$72.75
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$71.25
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$71.25
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$63.75
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$60.00
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$60.00
|
|
|
TR IMMUNIZATION ADMIN EA ADDTL VACCINE
|
Facility
IP
|
$38.00
|
|
|
Service Code
|
CPT 90472
|
| Hospital Charge Code |
20221105
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$26.60 |
| Max. Negotiated Rate |
$38.00 |
| Rate for Payer: AETNA Commercial |
$36.10
|
| Rate for Payer: AETNA Medicare |
$34.20
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$36.10
|
| Rate for Payer: BCBS Healthlink |
$34.20
|
| Rate for Payer: BCBS HMK CHIP |
$34.20
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$34.20
|
| Rate for Payer: BCBS POS |
$36.10
|
| Rate for Payer: BCBS Traditional |
$38.00
|
| Rate for Payer: CASH_PRICE |
$30.40
|
| Rate for Payer: CIGNA Commercial |
$36.10
|
| Rate for Payer: CIGNA Medicare |
$34.20
|
| Rate for Payer: HUMANA Commercial |
$34.20
|
| Rate for Payer: MEDICAID Medicaid |
$34.96
|
| Rate for Payer: MEDICARE Medicare |
$26.60
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$36.10
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$36.86
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$36.10
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$36.10
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$32.30
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$30.40
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$30.40
|
|
|
TR IMMUNIZATION ADMIN EA ADDTL VACCINE
|
Facility
OP
|
$38.00
|
|
|
Service Code
|
CPT 90472
|
| Hospital Charge Code |
20221105
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$26.60 |
| Max. Negotiated Rate |
$38.00 |
| Rate for Payer: AETNA Commercial |
$36.10
|
| Rate for Payer: AETNA Medicare |
$34.20
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$36.10
|
| Rate for Payer: BCBS Healthlink |
$34.20
|
| Rate for Payer: BCBS HMK CHIP |
$34.20
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$34.20
|
| Rate for Payer: BCBS POS |
$36.10
|
| Rate for Payer: BCBS Traditional |
$38.00
|
| Rate for Payer: CASH_PRICE |
$30.40
|
| Rate for Payer: CIGNA Commercial |
$36.10
|
| Rate for Payer: CIGNA Medicare |
$34.20
|
| Rate for Payer: HUMANA Commercial |
$34.20
|
| Rate for Payer: MEDICAID Medicaid |
$34.96
|
| Rate for Payer: MEDICARE Medicare |
$26.60
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$36.10
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$36.86
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$36.10
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$36.10
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$32.30
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$30.40
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$30.40
|
|
|
TR IMMUNIZATION ADMIN - SINGLE VACCINE
|
Facility
OP
|
$69.00
|
|
|
Service Code
|
CPT 90471
|
| Hospital Charge Code |
20221105
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$48.30 |
| Max. Negotiated Rate |
$69.00 |
| Rate for Payer: AETNA Commercial |
$65.55
|
| Rate for Payer: AETNA Medicare |
$62.10
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$65.55
|
| Rate for Payer: BCBS Healthlink |
$62.10
|
| Rate for Payer: BCBS HMK CHIP |
$62.10
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$62.10
|
| Rate for Payer: BCBS POS |
$65.55
|
| Rate for Payer: BCBS Traditional |
$69.00
|
| Rate for Payer: CASH_PRICE |
$55.20
|
| Rate for Payer: CIGNA Commercial |
$65.55
|
| Rate for Payer: CIGNA Medicare |
$62.10
|
| Rate for Payer: HUMANA Commercial |
$62.10
|
| Rate for Payer: MEDICAID Medicaid |
$63.48
|
| Rate for Payer: MEDICARE Medicare |
$48.30
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$65.55
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$66.93
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$65.55
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$65.55
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$58.65
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$55.20
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$55.20
|
|
|
TR IMMUNIZATION ADMIN - SINGLE VACCINE
|
Facility
IP
|
$69.00
|
|
|
Service Code
|
CPT 90471
|
| Hospital Charge Code |
20221105
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$48.30 |
| Max. Negotiated Rate |
$69.00 |
| Rate for Payer: UNITED HEALTHCARE Commercial |
$58.65
|
| Rate for Payer: AETNA Commercial |
$65.55
|
| Rate for Payer: AETNA Medicare |
$62.10
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$65.55
|
| Rate for Payer: BCBS Healthlink |
$62.10
|
| Rate for Payer: BCBS HMK CHIP |
$62.10
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$62.10
|
| Rate for Payer: BCBS POS |
$65.55
|
| Rate for Payer: BCBS Traditional |
$69.00
|
| Rate for Payer: CASH_PRICE |
$55.20
|
| Rate for Payer: CIGNA Commercial |
$65.55
|
| Rate for Payer: CIGNA Medicare |
$62.10
|
| Rate for Payer: HUMANA Commercial |
$62.10
|
| Rate for Payer: MEDICAID Medicaid |
$63.48
|
| Rate for Payer: MEDICARE Medicare |
$48.30
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$65.55
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$66.93
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$65.55
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$65.55
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$55.20
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$55.20
|
|
|
TR INCISION AND DRAINAGE
|
Facility
IP
|
$477.00
|
|
|
Service Code
|
CPT 27603
|
| Hospital Charge Code |
20221105
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$333.90 |
| Max. Negotiated Rate |
$477.00 |
| Rate for Payer: UNITED HEALTHCARE Commercial |
$405.45
|
| Rate for Payer: AETNA Commercial |
$453.15
|
| Rate for Payer: AETNA Medicare |
$429.30
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$453.15
|
| Rate for Payer: BCBS Healthlink |
$429.30
|
| Rate for Payer: BCBS HMK CHIP |
$429.30
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$429.30
|
| Rate for Payer: BCBS POS |
$453.15
|
| Rate for Payer: BCBS Traditional |
$477.00
|
| Rate for Payer: CASH_PRICE |
$381.60
|
| Rate for Payer: CIGNA Commercial |
$453.15
|
| Rate for Payer: CIGNA Medicare |
$429.30
|
| Rate for Payer: HUMANA Commercial |
$429.30
|
| Rate for Payer: MEDICAID Medicaid |
$438.84
|
| Rate for Payer: MEDICARE Medicare |
$333.90
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$453.15
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$462.69
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$453.15
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$453.15
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$381.60
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$381.60
|
|
