Ruby Valley Medical Center

All Charges

Charge

Type

Setting

Price

CELLPACK DCL 20L

Facility

$30.38

Hospital Charge Code	90197163
Hospital Revenue Code	270
Min. Negotiated Rate	$21.27
Max. Negotiated Rate	$30.38
Rate for Payer: Aetna Commercial	$28.86
Rate for Payer: Aetna Medicare	$27.34
Rate for Payer: BCBS MT CHIP	$27.34
Rate for Payer: BCBS MT Closed Plan Network	$28.86
Rate for Payer: BCBS MT HealthLink	$27.34
Rate for Payer: BCBS MT Medicare	$27.34
Rate for Payer: BCBS MT POS	$28.86
Rate for Payer: BCBS MT Traditional	$30.38
Rate for Payer: Cash Price	$27.34
Rate for Payer: Cigna Commercial	$28.86
Rate for Payer: Cigna Medicare	$27.34
Rate for Payer: Medicaid All Medicaid	$27.95
Rate for Payer: Medicare All Medicare	$21.27
Rate for Payer: Monida Allegiance	$28.86
Rate for Payer: Monida First Choice Health	$29.47
Rate for Payer: Monida Montana Health Co-op	$28.86
Rate for Payer: Monida PacificSource	$28.86

CELLPACK DCL 20L

Facility

$30.38

Hospital Charge Code	90197163
Hospital Revenue Code	270
Min. Negotiated Rate	$21.27
Max. Negotiated Rate	$30.38
Rate for Payer: Aetna Commercial	$28.86
Rate for Payer: Aetna Medicare	$27.34
Rate for Payer: BCBS MT CHIP	$27.34
Rate for Payer: BCBS MT Closed Plan Network	$28.86
Rate for Payer: BCBS MT HealthLink	$27.34
Rate for Payer: BCBS MT Medicare	$27.34
Rate for Payer: BCBS MT POS	$28.86
Rate for Payer: BCBS MT Traditional	$30.38
Rate for Payer: Cash Price	$27.34
Rate for Payer: Cigna Commercial	$28.86
Rate for Payer: Cigna Medicare	$27.34
Rate for Payer: Medicaid All Medicaid	$27.95
Rate for Payer: Medicare All Medicare	$21.27
Rate for Payer: Monida Allegiance	$28.86
Rate for Payer: Monida First Choice Health	$29.47
Rate for Payer: Monida Montana Health Co-op	$28.86
Rate for Payer: Monida PacificSource	$28.86

CELLPACK DFL 1.5L

Facility

$26.44

Hospital Charge Code	90197171
Hospital Revenue Code	270
Min. Negotiated Rate	$18.51
Max. Negotiated Rate	$26.44
Rate for Payer: Aetna Commercial	$25.12
Rate for Payer: Aetna Medicare	$23.80
Rate for Payer: BCBS MT CHIP	$23.80
Rate for Payer: BCBS MT Closed Plan Network	$25.12
Rate for Payer: BCBS MT HealthLink	$23.80
Rate for Payer: BCBS MT Medicare	$23.80
Rate for Payer: BCBS MT POS	$25.12
Rate for Payer: BCBS MT Traditional	$26.44
Rate for Payer: Cash Price	$23.80
Rate for Payer: Cigna Commercial	$25.12
Rate for Payer: Cigna Medicare	$23.80
Rate for Payer: Medicaid All Medicaid	$24.32
Rate for Payer: Medicare All Medicare	$18.51
Rate for Payer: Monida Allegiance	$25.12
Rate for Payer: Monida First Choice Health	$25.65
Rate for Payer: Monida Montana Health Co-op	$25.12
Rate for Payer: Monida PacificSource	$25.12

CELLPACK DFL 1.5L

Facility

$26.44

Hospital Charge Code	90197171
Hospital Revenue Code	270
Min. Negotiated Rate	$18.51
Max. Negotiated Rate	$26.44
Rate for Payer: Aetna Commercial	$25.12
Rate for Payer: Aetna Medicare	$23.80
Rate for Payer: BCBS MT CHIP	$23.80
Rate for Payer: BCBS MT Closed Plan Network	$25.12
Rate for Payer: BCBS MT HealthLink	$23.80
Rate for Payer: BCBS MT Medicare	$23.80
Rate for Payer: BCBS MT POS	$25.12
Rate for Payer: BCBS MT Traditional	$26.44
Rate for Payer: Cash Price	$23.80
Rate for Payer: Cigna Commercial	$25.12
Rate for Payer: Cigna Medicare	$23.80
Rate for Payer: Medicaid All Medicaid	$24.32
Rate for Payer: Medicare All Medicare	$18.51
Rate for Payer: Monida Allegiance	$25.12
Rate for Payer: Monida First Choice Health	$25.65
Rate for Payer: Monida Montana Health Co-op	$25.12
Rate for Payer: Monida PacificSource	$25.12

CENTRAL LINE DRESSING

Facility

$5.00

Hospital Charge Code	80040164
Hospital Revenue Code	270
Min. Negotiated Rate	$3.50
Max. Negotiated Rate	$5.00
Rate for Payer: Aetna Commercial	$4.75
Rate for Payer: Aetna Medicare	$4.50
Rate for Payer: BCBS MT CHIP	$4.50
Rate for Payer: BCBS MT Closed Plan Network	$4.75
Rate for Payer: BCBS MT HealthLink	$4.50
Rate for Payer: BCBS MT Medicare	$4.50
Rate for Payer: BCBS MT POS	$4.75
Rate for Payer: BCBS MT Traditional	$5.00
Rate for Payer: Cash Price	$4.50
Rate for Payer: Cigna Commercial	$4.75
Rate for Payer: Cigna Medicare	$4.50
Rate for Payer: Medicaid All Medicaid	$4.60
Rate for Payer: Medicare All Medicare	$3.50
Rate for Payer: Monida Allegiance	$4.75
Rate for Payer: Monida First Choice Health	$4.85
Rate for Payer: Monida Montana Health Co-op	$4.75
Rate for Payer: Monida PacificSource	$4.75

CENTRAL LINE DRESSING

Facility

$5.00

Hospital Charge Code	80040164
Hospital Revenue Code	270
Min. Negotiated Rate	$3.50
Max. Negotiated Rate	$5.00
Rate for Payer: Aetna Commercial	$4.75
Rate for Payer: Aetna Medicare	$4.50
Rate for Payer: BCBS MT CHIP	$4.50
Rate for Payer: BCBS MT Closed Plan Network	$4.75
Rate for Payer: BCBS MT HealthLink	$4.50
Rate for Payer: BCBS MT Medicare	$4.50
Rate for Payer: BCBS MT POS	$4.75
Rate for Payer: BCBS MT Traditional	$5.00
Rate for Payer: Cash Price	$4.50
Rate for Payer: Cigna Commercial	$4.75
Rate for Payer: Cigna Medicare	$4.50
Rate for Payer: Medicaid All Medicaid	$4.60
Rate for Payer: Medicare All Medicare	$3.50
Rate for Payer: Monida Allegiance	$4.75
Rate for Payer: Monida First Choice Health	$4.85
Rate for Payer: Monida Montana Health Co-op	$4.75
Rate for Payer: Monida PacificSource	$4.75

CENTRIFUGE

Facility

$411.15

Hospital Charge Code	90197144
Hospital Revenue Code	270
Min. Negotiated Rate	$287.81
Max. Negotiated Rate	$411.15
Rate for Payer: Aetna Commercial	$390.59
Rate for Payer: Aetna Medicare	$370.04
Rate for Payer: BCBS MT CHIP	$370.04
Rate for Payer: BCBS MT Closed Plan Network	$390.59
Rate for Payer: BCBS MT HealthLink	$370.04
Rate for Payer: BCBS MT Medicare	$370.04
Rate for Payer: BCBS MT POS	$390.59
Rate for Payer: BCBS MT Traditional	$411.15
Rate for Payer: Cash Price	$370.04
Rate for Payer: Cigna Commercial	$390.59
Rate for Payer: Cigna Medicare	$370.04
Rate for Payer: Medicaid All Medicaid	$378.26
Rate for Payer: Medicare All Medicare	$287.81
Rate for Payer: Monida Allegiance	$390.59
Rate for Payer: Monida First Choice Health	$398.82
Rate for Payer: Monida Montana Health Co-op	$390.59
Rate for Payer: Monida PacificSource	$390.59

CENTRIFUGE

Facility

$411.15

Hospital Charge Code	90197144
Hospital Revenue Code	270
Min. Negotiated Rate	$287.81
Max. Negotiated Rate	$411.15
Rate for Payer: Aetna Commercial	$390.59
Rate for Payer: Aetna Medicare	$370.04
Rate for Payer: BCBS MT CHIP	$370.04
Rate for Payer: BCBS MT Closed Plan Network	$390.59
Rate for Payer: BCBS MT HealthLink	$370.04
Rate for Payer: BCBS MT Medicare	$370.04
Rate for Payer: BCBS MT POS	$390.59
Rate for Payer: BCBS MT Traditional	$411.15
Rate for Payer: Cash Price	$370.04
Rate for Payer: Cigna Commercial	$390.59
Rate for Payer: Cigna Medicare	$370.04
Rate for Payer: Medicaid All Medicaid	$378.26
Rate for Payer: Medicare All Medicare	$287.81
Rate for Payer: Monida Allegiance	$390.59
Rate for Payer: Monida First Choice Health	$398.82
Rate for Payer: Monida Montana Health Co-op	$390.59
Rate for Payer: Monida PacificSource	$390.59

CENTROMERE AB

Facility

$75.00

Service Code	CPT 86038
Hospital Charge Code	4088094
Hospital Revenue Code	302
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 MT CHIP	$67.50
Rate for Payer: BCBS MT Closed Plan Network	$71.25
Rate for Payer: BCBS MT HealthLink	$67.50
Rate for Payer: BCBS MT Medicare	$67.50
Rate for Payer: BCBS MT POS	$71.25
Rate for Payer: BCBS MT Traditional	$75.00
Rate for Payer: Cash Price	$67.50
Rate for Payer: Cigna Commercial	$71.25
Rate for Payer: Cigna Medicare	$67.50
Rate for Payer: Medicaid All Medicaid	$69.00
Rate for Payer: Medicare All Medicare	$52.50
Rate for Payer: Monida Allegiance	$71.25
Rate for Payer: Monida First Choice Health	$72.75
Rate for Payer: Monida Montana Health Co-op	$71.25
Rate for Payer: Monida PacificSource	$71.25

CENTROMERE AB

Facility

$75.00

Service Code	CPT 86038
Hospital Charge Code	4088094
Hospital Revenue Code	302
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 MT CHIP	$67.50
Rate for Payer: BCBS MT Closed Plan Network	$71.25
Rate for Payer: BCBS MT HealthLink	$67.50
Rate for Payer: BCBS MT Medicare	$67.50
Rate for Payer: BCBS MT POS	$71.25
Rate for Payer: BCBS MT Traditional	$75.00
Rate for Payer: Cash Price	$67.50
Rate for Payer: Cigna Commercial	$71.25
Rate for Payer: Cigna Medicare	$67.50
Rate for Payer: Medicaid All Medicaid	$69.00
Rate for Payer: Medicare All Medicare	$52.50
Rate for Payer: Monida Allegiance	$71.25
Rate for Payer: Monida First Choice Health	$72.75
Rate for Payer: Monida Montana Health Co-op	$71.25
Rate for Payer: Monida PacificSource	$71.25

CEPHALEXIN CAP [250 MG]

Facility

$8.00

Service Code	HCPCS J8499
Hospital Charge Code	3000078
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 MT CHIP	$7.20
Rate for Payer: BCBS MT Closed Plan Network	$7.60
Rate for Payer: BCBS MT HealthLink	$7.20
Rate for Payer: BCBS MT Medicare	$7.20
Rate for Payer: BCBS MT POS	$7.60
Rate for Payer: BCBS MT Traditional	$8.00
Rate for Payer: Cash Price	$7.20
Rate for Payer: Cigna Commercial	$7.60
Rate for Payer: Cigna Medicare	$7.20
Rate for Payer: Medicaid All Medicaid	$7.36
Rate for Payer: Medicare All Medicare	$5.60
Rate for Payer: Monida Allegiance	$7.60
Rate for Payer: Monida First Choice Health	$7.76
Rate for Payer: Monida Montana Health Co-op	$7.60
Rate for Payer: Monida PacificSource	$7.60

CEPHALEXIN CAP [250 MG]

Facility

$8.00

Service Code	HCPCS J8499
Hospital Charge Code	3000078
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 MT CHIP	$7.20
Rate for Payer: BCBS MT Closed Plan Network	$7.60
Rate for Payer: BCBS MT HealthLink	$7.20
Rate for Payer: BCBS MT Medicare	$7.20
Rate for Payer: BCBS MT POS	$7.60
Rate for Payer: BCBS MT Traditional	$8.00
Rate for Payer: Cash Price	$7.20
Rate for Payer: Cigna Commercial	$7.60
Rate for Payer: Cigna Medicare	$7.20
Rate for Payer: Medicaid All Medicaid	$7.36
Rate for Payer: Medicare All Medicare	$5.60
Rate for Payer: Monida Allegiance	$7.60
Rate for Payer: Monida First Choice Health	$7.76
Rate for Payer: Monida Montana Health Co-op	$7.60
Rate for Payer: Monida PacificSource	$7.60

CEPHALEXIN CAP [500 MG]

Facility

$8.00

Service Code	HCPCS J8499
Hospital Charge Code	3000079
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 MT CHIP	$7.20
Rate for Payer: BCBS MT Closed Plan Network	$7.60
Rate for Payer: BCBS MT HealthLink	$7.20
Rate for Payer: BCBS MT Medicare	$7.20
Rate for Payer: BCBS MT POS	$7.60
Rate for Payer: BCBS MT Traditional	$8.00
Rate for Payer: Cash Price	$7.20
Rate for Payer: Cigna Commercial	$7.60
Rate for Payer: Cigna Medicare	$7.20
Rate for Payer: Medicaid All Medicaid	$7.36
Rate for Payer: Medicare All Medicare	$5.60
Rate for Payer: Monida Allegiance	$7.60
Rate for Payer: Monida First Choice Health	$7.76
Rate for Payer: Monida Montana Health Co-op	$7.60
Rate for Payer: Monida PacificSource	$7.60

CEPHALEXIN CAP [500 MG]

Facility

$8.00

Service Code	HCPCS J8499
Hospital Charge Code	3000079
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 MT CHIP	$7.20
Rate for Payer: BCBS MT Closed Plan Network	$7.60
Rate for Payer: BCBS MT HealthLink	$7.20
Rate for Payer: BCBS MT Medicare	$7.20
Rate for Payer: BCBS MT POS	$7.60
Rate for Payer: BCBS MT Traditional	$8.00
Rate for Payer: Cash Price	$7.20
Rate for Payer: Cigna Commercial	$7.60
Rate for Payer: Cigna Medicare	$7.20
Rate for Payer: Medicaid All Medicaid	$7.36
Rate for Payer: Medicare All Medicare	$5.60
Rate for Payer: Monida Allegiance	$7.60
Rate for Payer: Monida First Choice Health	$7.76
Rate for Payer: Monida Montana Health Co-op	$7.60
Rate for Payer: Monida PacificSource	$7.60

CEPHALEXIN SUSP [125 MG/5 ML] 100 ML

Facility

$76.00

Service Code	HCPCS J8499
Hospital Charge Code	3000080
Hospital Revenue Code	250
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 MT CHIP	$68.40
Rate for Payer: BCBS MT Closed Plan Network	$72.20
Rate for Payer: BCBS MT HealthLink	$68.40
Rate for Payer: BCBS MT Medicare	$68.40
Rate for Payer: BCBS MT POS	$72.20
Rate for Payer: BCBS MT Traditional	$76.00
Rate for Payer: Cash Price	$68.40
Rate for Payer: Cigna Commercial	$72.20
Rate for Payer: Cigna Medicare	$68.40
Rate for Payer: Medicaid All Medicaid	$69.92
Rate for Payer: Medicare All Medicare	$53.20
Rate for Payer: Monida Allegiance	$72.20
Rate for Payer: Monida First Choice Health	$73.72
Rate for Payer: Monida Montana Health Co-op	$72.20
Rate for Payer: Monida PacificSource	$72.20

CEPHALEXIN SUSP [125 MG/5 ML] 100 ML

Facility

$76.00

Service Code	HCPCS J8499
Hospital Charge Code	3000080
Hospital Revenue Code	250
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 MT CHIP	$68.40
Rate for Payer: BCBS MT Closed Plan Network	$72.20
Rate for Payer: BCBS MT HealthLink	$68.40
Rate for Payer: BCBS MT Medicare	$68.40
Rate for Payer: BCBS MT POS	$72.20
Rate for Payer: BCBS MT Traditional	$76.00
Rate for Payer: Cash Price	$68.40
Rate for Payer: Cigna Commercial	$72.20
Rate for Payer: Cigna Medicare	$68.40
Rate for Payer: Medicaid All Medicaid	$69.92
Rate for Payer: Medicare All Medicare	$53.20
Rate for Payer: Monida Allegiance	$72.20
Rate for Payer: Monida First Choice Health	$73.72
Rate for Payer: Monida Montana Health Co-op	$72.20
Rate for Payer: Monida PacificSource	$72.20

CEPHALEXIN SUSP [250 MG/5 ML] 100 ML

Facility

$92.00

Service Code	HCPCS J8499
Hospital Charge Code	3000081
Hospital Revenue Code	250
Min. Negotiated Rate	$64.40
Max. Negotiated Rate	$92.00
Rate for Payer: Aetna Commercial	$87.40
Rate for Payer: Aetna Medicare	$82.80
Rate for Payer: BCBS MT CHIP	$82.80
Rate for Payer: BCBS MT Closed Plan Network	$87.40
Rate for Payer: BCBS MT HealthLink	$82.80
Rate for Payer: BCBS MT Medicare	$82.80
Rate for Payer: BCBS MT POS	$87.40
Rate for Payer: BCBS MT Traditional	$92.00
Rate for Payer: Cash Price	$82.80
Rate for Payer: Cigna Commercial	$87.40
Rate for Payer: Cigna Medicare	$82.80
Rate for Payer: Medicaid All Medicaid	$84.64
Rate for Payer: Medicare All Medicare	$64.40
Rate for Payer: Monida Allegiance	$87.40
Rate for Payer: Monida First Choice Health	$89.24
Rate for Payer: Monida Montana Health Co-op	$87.40
Rate for Payer: Monida PacificSource	$87.40

CEPHALEXIN SUSP [250 MG/5 ML] 100 ML

Facility

$92.00

Service Code	HCPCS J8499
Hospital Charge Code	3000081
Hospital Revenue Code	250
Min. Negotiated Rate	$64.40
Max. Negotiated Rate	$92.00
Rate for Payer: Aetna Commercial	$87.40
Rate for Payer: Aetna Medicare	$82.80
Rate for Payer: BCBS MT CHIP	$82.80
Rate for Payer: BCBS MT Closed Plan Network	$87.40
Rate for Payer: BCBS MT HealthLink	$82.80
Rate for Payer: BCBS MT Medicare	$82.80
Rate for Payer: BCBS MT POS	$87.40
Rate for Payer: BCBS MT Traditional	$92.00
Rate for Payer: Cash Price	$82.80
Rate for Payer: Cigna Commercial	$87.40
Rate for Payer: Cigna Medicare	$82.80
Rate for Payer: Medicaid All Medicaid	$84.64
Rate for Payer: Medicare All Medicare	$64.40
Rate for Payer: Monida Allegiance	$87.40
Rate for Payer: Monida First Choice Health	$89.24
Rate for Payer: Monida Montana Health Co-op	$87.40
Rate for Payer: Monida PacificSource	$87.40

CEPHEID CT/NG

Facility

$370.27

Hospital Charge Code	90197106
Hospital Revenue Code	270
Min. Negotiated Rate	$259.19
Max. Negotiated Rate	$370.27
Rate for Payer: Aetna Commercial	$351.76
Rate for Payer: Aetna Medicare	$333.24
Rate for Payer: BCBS MT CHIP	$333.24
Rate for Payer: BCBS MT Closed Plan Network	$351.76
Rate for Payer: BCBS MT HealthLink	$333.24
Rate for Payer: BCBS MT Medicare	$333.24
Rate for Payer: BCBS MT POS	$351.76
Rate for Payer: BCBS MT Traditional	$370.27
Rate for Payer: Cash Price	$333.24
Rate for Payer: Cigna Commercial	$351.76
Rate for Payer: Cigna Medicare	$333.24
Rate for Payer: Medicaid All Medicaid	$340.65
Rate for Payer: Medicare All Medicare	$259.19
Rate for Payer: Monida Allegiance	$351.76
Rate for Payer: Monida First Choice Health	$359.16
Rate for Payer: Monida Montana Health Co-op	$351.76
Rate for Payer: Monida PacificSource	$351.76

CEPHEID CT/NG

Facility

$370.27

Hospital Charge Code	90197106
Hospital Revenue Code	270
Min. Negotiated Rate	$259.19
Max. Negotiated Rate	$370.27
Rate for Payer: Aetna Commercial	$351.76
Rate for Payer: Aetna Medicare	$333.24
Rate for Payer: BCBS MT CHIP	$333.24
Rate for Payer: BCBS MT Closed Plan Network	$351.76
Rate for Payer: BCBS MT HealthLink	$333.24
Rate for Payer: BCBS MT Medicare	$333.24
Rate for Payer: BCBS MT POS	$351.76
Rate for Payer: BCBS MT Traditional	$370.27
Rate for Payer: Cash Price	$333.24
Rate for Payer: Cigna Commercial	$351.76
Rate for Payer: Cigna Medicare	$333.24
Rate for Payer: Medicaid All Medicaid	$340.65
Rate for Payer: Medicare All Medicare	$259.19
Rate for Payer: Monida Allegiance	$351.76
Rate for Payer: Monida First Choice Health	$359.16
Rate for Payer: Monida Montana Health Co-op	$351.76
Rate for Payer: Monida PacificSource	$351.76

CEPHEID CTNG COLLECTION KIT

Facility

$115.00

Hospital Charge Code	90197108
Hospital Revenue Code	270
Min. Negotiated Rate	$80.50
Max. Negotiated Rate	$115.00
Rate for Payer: Aetna Commercial	$109.25
Rate for Payer: Aetna Medicare	$103.50
Rate for Payer: BCBS MT CHIP	$103.50
Rate for Payer: BCBS MT Closed Plan Network	$109.25
Rate for Payer: BCBS MT HealthLink	$103.50
Rate for Payer: BCBS MT Medicare	$103.50
Rate for Payer: BCBS MT POS	$109.25
Rate for Payer: BCBS MT Traditional	$115.00
Rate for Payer: Cash Price	$103.50
Rate for Payer: Cigna Commercial	$109.25
Rate for Payer: Cigna Medicare	$103.50
Rate for Payer: Medicaid All Medicaid	$105.80
Rate for Payer: Medicare All Medicare	$80.50
Rate for Payer: Monida Allegiance	$109.25
Rate for Payer: Monida First Choice Health	$111.55
Rate for Payer: Monida Montana Health Co-op	$109.25
Rate for Payer: Monida PacificSource	$109.25

CEPHEID CTNG COLLECTION KIT

Facility

$115.00

Hospital Charge Code	90197108
Hospital Revenue Code	270
Min. Negotiated Rate	$80.50
Max. Negotiated Rate	$115.00
Rate for Payer: Aetna Commercial	$109.25
Rate for Payer: Aetna Medicare	$103.50
Rate for Payer: BCBS MT CHIP	$103.50
Rate for Payer: BCBS MT Closed Plan Network	$109.25
Rate for Payer: BCBS MT HealthLink	$103.50
Rate for Payer: BCBS MT Medicare	$103.50
Rate for Payer: BCBS MT POS	$109.25
Rate for Payer: BCBS MT Traditional	$115.00
Rate for Payer: Cash Price	$103.50
Rate for Payer: Cigna Commercial	$109.25
Rate for Payer: Cigna Medicare	$103.50
Rate for Payer: Medicaid All Medicaid	$105.80
Rate for Payer: Medicare All Medicare	$80.50
Rate for Payer: Monida Allegiance	$109.25
Rate for Payer: Monida First Choice Health	$111.55
Rate for Payer: Monida Montana Health Co-op	$109.25
Rate for Payer: Monida PacificSource	$109.25

CEPHEID GENEXPERT SERVICE AGREEMENT

Facility

$5,571.00

Hospital Charge Code	90197016
Hospital Revenue Code	270
Min. Negotiated Rate	$3,899.70
Max. Negotiated Rate	$5,571.00
Rate for Payer: Aetna Commercial	$5,292.45
Rate for Payer: Aetna Medicare	$5,013.90
Rate for Payer: BCBS MT CHIP	$5,013.90
Rate for Payer: BCBS MT Closed Plan Network	$5,292.45
Rate for Payer: BCBS MT HealthLink	$5,013.90
Rate for Payer: BCBS MT Medicare	$5,013.90
Rate for Payer: BCBS MT POS	$5,292.45
Rate for Payer: BCBS MT Traditional	$5,571.00
Rate for Payer: Cash Price	$5,013.90
Rate for Payer: Cigna Commercial	$5,292.45
Rate for Payer: Cigna Medicare	$5,013.90
Rate for Payer: Medicaid All Medicaid	$5,125.32
Rate for Payer: Medicare All Medicare	$3,899.70
Rate for Payer: Monida Allegiance	$5,292.45
Rate for Payer: Monida First Choice Health	$5,403.87
Rate for Payer: Monida Montana Health Co-op	$5,292.45
Rate for Payer: Monida PacificSource	$5,292.45

CEPHEID GENEXPERT SERVICE AGREEMENT

Facility

$5,571.00

Hospital Charge Code	90197016
Hospital Revenue Code	270
Min. Negotiated Rate	$3,899.70
Max. Negotiated Rate	$5,571.00
Rate for Payer: Aetna Commercial	$5,292.45
Rate for Payer: Aetna Medicare	$5,013.90
Rate for Payer: BCBS MT CHIP	$5,013.90
Rate for Payer: BCBS MT Closed Plan Network	$5,292.45
Rate for Payer: BCBS MT HealthLink	$5,013.90
Rate for Payer: BCBS MT Medicare	$5,013.90
Rate for Payer: BCBS MT POS	$5,292.45
Rate for Payer: BCBS MT Traditional	$5,571.00
Rate for Payer: Cash Price	$5,013.90
Rate for Payer: Cigna Commercial	$5,292.45
Rate for Payer: Cigna Medicare	$5,013.90
Rate for Payer: Medicaid All Medicaid	$5,125.32
Rate for Payer: Medicare All Medicare	$3,899.70
Rate for Payer: Monida Allegiance	$5,292.45
Rate for Payer: Monida First Choice Health	$5,403.87
Rate for Payer: Monida Montana Health Co-op	$5,292.45
Rate for Payer: Monida PacificSource	$5,292.45

CEPHEID MRSAMSSA KIT

Facility

$730.81

Hospital Charge Code	90197159
Hospital Revenue Code	270
Min. Negotiated Rate	$511.57
Max. Negotiated Rate	$730.81
Rate for Payer: Aetna Commercial	$694.27
Rate for Payer: Aetna Medicare	$657.73
Rate for Payer: BCBS MT CHIP	$657.73
Rate for Payer: BCBS MT Closed Plan Network	$694.27
Rate for Payer: BCBS MT HealthLink	$657.73
Rate for Payer: BCBS MT Medicare	$657.73
Rate for Payer: BCBS MT POS	$694.27
Rate for Payer: BCBS MT Traditional	$730.81
Rate for Payer: Cash Price	$657.73
Rate for Payer: Cigna Commercial	$694.27
Rate for Payer: Cigna Medicare	$657.73
Rate for Payer: Medicaid All Medicaid	$672.35
Rate for Payer: Medicare All Medicare	$511.57
Rate for Payer: Monida Allegiance	$694.27
Rate for Payer: Monida First Choice Health	$708.89
Rate for Payer: Monida Montana Health Co-op	$694.27
Rate for Payer: Monida PacificSource	$694.27

Know your out-of-pocket cost for care.

All Charges