|
ER APPLICATION STRAPPING ELBOW OR WRIST
|
Facility
OP
|
$191.00
|
|
|
Service Code
|
CPT 29260
|
| Hospital Charge Code |
20221105
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$133.70 |
| Max. Negotiated Rate |
$191.00 |
| Rate for Payer: AETNA Commercial |
$181.45
|
| Rate for Payer: AETNA Medicare |
$171.90
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$181.45
|
| Rate for Payer: BCBS Healthlink |
$171.90
|
| Rate for Payer: BCBS HMK CHIP |
$171.90
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$171.90
|
| Rate for Payer: BCBS POS |
$181.45
|
| Rate for Payer: BCBS Traditional |
$191.00
|
| Rate for Payer: CASH_PRICE |
$152.80
|
| Rate for Payer: CIGNA Commercial |
$181.45
|
| Rate for Payer: CIGNA Medicare |
$171.90
|
| Rate for Payer: HUMANA Commercial |
$171.90
|
| Rate for Payer: MEDICAID Medicaid |
$175.72
|
| Rate for Payer: MEDICARE Medicare |
$133.70
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$181.45
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$185.27
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$181.45
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$181.45
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$162.35
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$152.80
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$152.80
|
|
|
ER APPLICATION STRAPPING SHOULDER
|
Facility
OP
|
$307.00
|
|
|
Service Code
|
CPT 29240
|
| Hospital Charge Code |
20221105
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$214.90 |
| Max. Negotiated Rate |
$307.00 |
| Rate for Payer: AETNA Commercial |
$291.65
|
| Rate for Payer: AETNA Medicare |
$276.30
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$291.65
|
| Rate for Payer: BCBS Healthlink |
$276.30
|
| Rate for Payer: BCBS HMK CHIP |
$276.30
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$276.30
|
| Rate for Payer: BCBS POS |
$291.65
|
| Rate for Payer: BCBS Traditional |
$307.00
|
| Rate for Payer: CASH_PRICE |
$245.60
|
| Rate for Payer: CIGNA Commercial |
$291.65
|
| Rate for Payer: CIGNA Medicare |
$276.30
|
| Rate for Payer: HUMANA Commercial |
$276.30
|
| Rate for Payer: MEDICAID Medicaid |
$282.44
|
| Rate for Payer: MEDICARE Medicare |
$214.90
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$291.65
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$297.79
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$291.65
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$291.65
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$260.95
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$245.60
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$245.60
|
|
|
ER APPLICATION STRAPPING SHOULDER
|
Facility
IP
|
$307.00
|
|
|
Service Code
|
CPT 29240
|
| Hospital Charge Code |
20221105
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$214.90 |
| Max. Negotiated Rate |
$307.00 |
| Rate for Payer: AETNA Commercial |
$291.65
|
| Rate for Payer: AETNA Medicare |
$276.30
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$291.65
|
| Rate for Payer: BCBS Healthlink |
$276.30
|
| Rate for Payer: BCBS HMK CHIP |
$276.30
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$276.30
|
| Rate for Payer: BCBS POS |
$291.65
|
| Rate for Payer: BCBS Traditional |
$307.00
|
| Rate for Payer: CASH_PRICE |
$245.60
|
| Rate for Payer: CIGNA Commercial |
$291.65
|
| Rate for Payer: CIGNA Medicare |
$276.30
|
| Rate for Payer: HUMANA Commercial |
$276.30
|
| Rate for Payer: MEDICAID Medicaid |
$282.44
|
| Rate for Payer: MEDICARE Medicare |
$214.90
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$291.65
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$297.79
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$291.65
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$291.65
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$260.95
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$245.60
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$245.60
|
|
|
ER APPLY LONG LEG CAST
|
Facility
OP
|
$328.00
|
|
|
Service Code
|
CPT 29345
|
| Hospital Charge Code |
20221105
|
|
Hospital Revenue Code
|
450
|
| 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
|
|
|
ER APPLY LONG LEG CAST
|
Facility
IP
|
$328.00
|
|
|
Service Code
|
CPT 29345
|
| Hospital Charge Code |
20221105
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$229.60 |
| Max. Negotiated Rate |
$328.00 |
| Rate for Payer: BCBS HMK CHIP |
$295.20
|
| 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 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
|
|
|
ER APPLY SHORT LEG CAST
|
Facility
OP
|
$278.00
|
|
|
Service Code
|
CPT 29405
|
| Hospital Charge Code |
20221105
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$194.60 |
| Max. Negotiated Rate |
$278.00 |
| Rate for Payer: AETNA Commercial |
$264.10
|
| Rate for Payer: AETNA Medicare |
$250.20
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$264.10
|
| Rate for Payer: BCBS Healthlink |
$250.20
|
| Rate for Payer: BCBS HMK CHIP |
$250.20
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$250.20
|
| Rate for Payer: BCBS POS |
$264.10
|
| Rate for Payer: BCBS Traditional |
$278.00
|
| Rate for Payer: CASH_PRICE |
$222.40
|
| Rate for Payer: CIGNA Commercial |
$264.10
|
| Rate for Payer: CIGNA Medicare |
$250.20
|
| Rate for Payer: HUMANA Commercial |
$250.20
|
| Rate for Payer: MEDICAID Medicaid |
$255.76
|
| Rate for Payer: MEDICARE Medicare |
$194.60
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$264.10
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$269.66
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$264.10
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$264.10
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$236.30
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$222.40
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$222.40
|
|
|
ER APPLY SHORT LEG CAST
|
Facility
IP
|
$278.00
|
|
|
Service Code
|
CPT 29405
|
| Hospital Charge Code |
20221105
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$194.60 |
| Max. Negotiated Rate |
$278.00 |
| Rate for Payer: AETNA Commercial |
$264.10
|
| Rate for Payer: AETNA Medicare |
$250.20
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$264.10
|
| Rate for Payer: BCBS Healthlink |
$250.20
|
| Rate for Payer: BCBS HMK CHIP |
$250.20
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$250.20
|
| Rate for Payer: BCBS POS |
$264.10
|
| Rate for Payer: BCBS Traditional |
$278.00
|
| Rate for Payer: CASH_PRICE |
$222.40
|
| Rate for Payer: CIGNA Commercial |
$264.10
|
| Rate for Payer: CIGNA Medicare |
$250.20
|
| Rate for Payer: HUMANA Commercial |
$250.20
|
| Rate for Payer: MEDICAID Medicaid |
$255.76
|
| Rate for Payer: MEDICARE Medicare |
$194.60
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$264.10
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$269.66
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$264.10
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$264.10
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$236.30
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$222.40
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$222.40
|
|
|
ER CARDIOPULMONARY RESUSCITATION
|
Facility
IP
|
$825.00
|
|
|
Service Code
|
CPT 92950
|
| Hospital Charge Code |
20221105
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$577.50 |
| Max. Negotiated Rate |
$825.00 |
| Rate for Payer: BCBS HMK CHIP |
$742.50
|
| Rate for Payer: AETNA Commercial |
$783.75
|
| Rate for Payer: AETNA Medicare |
$742.50
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$783.75
|
| Rate for Payer: BCBS Healthlink |
$742.50
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$742.50
|
| Rate for Payer: BCBS POS |
$783.75
|
| Rate for Payer: BCBS Traditional |
$825.00
|
| Rate for Payer: CASH_PRICE |
$660.00
|
| Rate for Payer: CIGNA Commercial |
$783.75
|
| Rate for Payer: CIGNA Medicare |
$742.50
|
| Rate for Payer: HUMANA Commercial |
$742.50
|
| Rate for Payer: MEDICAID Medicaid |
$759.00
|
| Rate for Payer: MEDICARE Medicare |
$577.50
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$783.75
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$800.25
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$783.75
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$783.75
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$701.25
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$660.00
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$660.00
|
|
|
ER CARDIOPULMONARY RESUSCITATION
|
Facility
OP
|
$825.00
|
|
|
Service Code
|
CPT 92950
|
| Hospital Charge Code |
20221105
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$577.50 |
| Max. Negotiated Rate |
$825.00 |
| Rate for Payer: AETNA Commercial |
$783.75
|
| Rate for Payer: AETNA Medicare |
$742.50
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$783.75
|
| Rate for Payer: BCBS Healthlink |
$742.50
|
| Rate for Payer: BCBS HMK CHIP |
$742.50
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$742.50
|
| Rate for Payer: BCBS POS |
$783.75
|
| Rate for Payer: BCBS Traditional |
$825.00
|
| Rate for Payer: CASH_PRICE |
$660.00
|
| Rate for Payer: CIGNA Commercial |
$783.75
|
| Rate for Payer: CIGNA Medicare |
$742.50
|
| Rate for Payer: HUMANA Commercial |
$742.50
|
| Rate for Payer: MEDICAID Medicaid |
$759.00
|
| Rate for Payer: MEDICARE Medicare |
$577.50
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$783.75
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$800.25
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$783.75
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$783.75
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$701.25
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$660.00
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$660.00
|
|
|
ER CARDIOVERSION ELECTIVE EXTERNAL(DEFIB
|
Facility
OP
|
$1,450.00
|
|
|
Service Code
|
CPT 92960
|
| Hospital Charge Code |
20221105
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,015.00 |
| Max. Negotiated Rate |
$1,450.00 |
| Rate for Payer: AETNA Commercial |
$1,377.50
|
| Rate for Payer: AETNA Medicare |
$1,305.00
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$1,377.50
|
| Rate for Payer: BCBS Healthlink |
$1,305.00
|
| Rate for Payer: BCBS HMK CHIP |
$1,305.00
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$1,305.00
|
| Rate for Payer: BCBS POS |
$1,377.50
|
| Rate for Payer: BCBS Traditional |
$1,450.00
|
| Rate for Payer: CASH_PRICE |
$1,160.00
|
| Rate for Payer: CIGNA Commercial |
$1,377.50
|
| Rate for Payer: CIGNA Medicare |
$1,305.00
|
| Rate for Payer: HUMANA Commercial |
$1,305.00
|
| Rate for Payer: MEDICAID Medicaid |
$1,334.00
|
| Rate for Payer: MEDICARE Medicare |
$1,015.00
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$1,377.50
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$1,406.50
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$1,377.50
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$1,377.50
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$1,232.50
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$1,160.00
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$1,160.00
|
|
|
ER CARDIOVERSION ELECTIVE EXTERNAL(DEFIB
|
Facility
IP
|
$1,450.00
|
|
|
Service Code
|
CPT 92960
|
| Hospital Charge Code |
20221105
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,015.00 |
| Max. Negotiated Rate |
$1,450.00 |
| Rate for Payer: AETNA Commercial |
$1,377.50
|
| Rate for Payer: AETNA Medicare |
$1,305.00
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$1,377.50
|
| Rate for Payer: BCBS Healthlink |
$1,305.00
|
| Rate for Payer: BCBS HMK CHIP |
$1,305.00
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$1,305.00
|
| Rate for Payer: BCBS POS |
$1,377.50
|
| Rate for Payer: BCBS Traditional |
$1,450.00
|
| Rate for Payer: CASH_PRICE |
$1,160.00
|
| Rate for Payer: CIGNA Commercial |
$1,377.50
|
| Rate for Payer: CIGNA Medicare |
$1,305.00
|
| Rate for Payer: HUMANA Commercial |
$1,305.00
|
| Rate for Payer: MEDICAID Medicaid |
$1,334.00
|
| Rate for Payer: MEDICARE Medicare |
$1,015.00
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$1,377.50
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$1,406.50
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$1,377.50
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$1,377.50
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$1,232.50
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$1,160.00
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$1,160.00
|
|
|
ER CATH ASP NASOTRACHEAL
|
Facility
OP
|
$187.00
|
|
|
Service Code
|
CPT 31720
|
| Hospital Charge Code |
20221105
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$130.90 |
| Max. Negotiated Rate |
$187.00 |
| Rate for Payer: AETNA Commercial |
$177.65
|
| Rate for Payer: AETNA Medicare |
$168.30
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$177.65
|
| Rate for Payer: BCBS Healthlink |
$168.30
|
| Rate for Payer: BCBS HMK CHIP |
$168.30
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$168.30
|
| Rate for Payer: BCBS POS |
$177.65
|
| Rate for Payer: BCBS Traditional |
$187.00
|
| Rate for Payer: CASH_PRICE |
$149.60
|
| Rate for Payer: CIGNA Commercial |
$177.65
|
| Rate for Payer: CIGNA Medicare |
$168.30
|
| Rate for Payer: HUMANA Commercial |
$168.30
|
| Rate for Payer: MEDICAID Medicaid |
$172.04
|
| Rate for Payer: MEDICARE Medicare |
$130.90
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$177.65
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$181.39
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$177.65
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$177.65
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$158.95
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$149.60
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$149.60
|
|
|
ER CATH ASP NASOTRACHEAL
|
Facility
IP
|
$187.00
|
|
|
Service Code
|
CPT 31720
|
| Hospital Charge Code |
20221105
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$130.90 |
| Max. Negotiated Rate |
$187.00 |
| Rate for Payer: BCBS HMK CHIP |
$168.30
|
| Rate for Payer: AETNA Commercial |
$177.65
|
| Rate for Payer: AETNA Medicare |
$168.30
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$177.65
|
| Rate for Payer: BCBS Healthlink |
$168.30
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$168.30
|
| Rate for Payer: BCBS POS |
$177.65
|
| Rate for Payer: BCBS Traditional |
$187.00
|
| Rate for Payer: CASH_PRICE |
$149.60
|
| Rate for Payer: CIGNA Commercial |
$177.65
|
| Rate for Payer: CIGNA Medicare |
$168.30
|
| Rate for Payer: HUMANA Commercial |
$168.30
|
| Rate for Payer: MEDICAID Medicaid |
$172.04
|
| Rate for Payer: MEDICARE Medicare |
$130.90
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$177.65
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$181.39
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$177.65
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$177.65
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$158.95
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$149.60
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$149.60
|
|
|
ER CLOSED DISLOCATION ELBOW
|
Facility
IP
|
$546.00
|
|
|
Service Code
|
CPT 24600
|
| Hospital Charge Code |
20221105
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$382.20 |
| Max. Negotiated Rate |
$546.00 |
| Rate for Payer: AETNA Commercial |
$518.70
|
| Rate for Payer: AETNA Medicare |
$491.40
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$518.70
|
| Rate for Payer: BCBS Healthlink |
$491.40
|
| Rate for Payer: BCBS HMK CHIP |
$491.40
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$491.40
|
| Rate for Payer: BCBS POS |
$518.70
|
| Rate for Payer: BCBS Traditional |
$546.00
|
| Rate for Payer: CASH_PRICE |
$436.80
|
| Rate for Payer: CIGNA Commercial |
$518.70
|
| Rate for Payer: CIGNA Medicare |
$491.40
|
| Rate for Payer: HUMANA Commercial |
$491.40
|
| Rate for Payer: MEDICAID Medicaid |
$502.32
|
| Rate for Payer: MEDICARE Medicare |
$382.20
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$518.70
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$529.62
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$518.70
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$518.70
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$464.10
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$436.80
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$436.80
|
|
|
ER CLOSED DISLOCATION ELBOW
|
Facility
OP
|
$546.00
|
|
|
Service Code
|
CPT 24600
|
| Hospital Charge Code |
20221105
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$382.20 |
| Max. Negotiated Rate |
$546.00 |
| Rate for Payer: AETNA Commercial |
$518.70
|
| Rate for Payer: AETNA Medicare |
$491.40
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$518.70
|
| Rate for Payer: BCBS Healthlink |
$491.40
|
| Rate for Payer: BCBS HMK CHIP |
$491.40
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$491.40
|
| Rate for Payer: BCBS POS |
$518.70
|
| Rate for Payer: BCBS Traditional |
$546.00
|
| Rate for Payer: CASH_PRICE |
$436.80
|
| Rate for Payer: CIGNA Commercial |
$518.70
|
| Rate for Payer: CIGNA Medicare |
$491.40
|
| Rate for Payer: HUMANA Commercial |
$491.40
|
| Rate for Payer: MEDICAID Medicaid |
$502.32
|
| Rate for Payer: MEDICARE Medicare |
$382.20
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$518.70
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$529.62
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$518.70
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$518.70
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$464.10
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$436.80
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$436.80
|
|
|
ER CLOSED DISLOCATION OF THE TARSAL BONE
|
Facility
IP
|
$404.00
|
|
|
Service Code
|
CPT 28540
|
| Hospital Charge Code |
20221105
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$282.80 |
| Max. Negotiated Rate |
$404.00 |
| Rate for Payer: BCBS HMK CHIP |
$363.60
|
| Rate for Payer: AETNA Commercial |
$383.80
|
| Rate for Payer: AETNA Medicare |
$363.60
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$383.80
|
| Rate for Payer: BCBS Healthlink |
$363.60
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$363.60
|
| Rate for Payer: BCBS POS |
$383.80
|
| Rate for Payer: BCBS Traditional |
$404.00
|
| Rate for Payer: CASH_PRICE |
$323.20
|
| Rate for Payer: CIGNA Commercial |
$383.80
|
| Rate for Payer: CIGNA Medicare |
$363.60
|
| Rate for Payer: HUMANA Commercial |
$363.60
|
| Rate for Payer: MEDICAID Medicaid |
$371.68
|
| Rate for Payer: MEDICARE Medicare |
$282.80
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$383.80
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$391.88
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$383.80
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$383.80
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$343.40
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$323.20
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$323.20
|
|
|
ER CLOSED DISLOCATION OF THE TARSAL BONE
|
Facility
OP
|
$404.00
|
|
|
Service Code
|
CPT 28540
|
| Hospital Charge Code |
20221105
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$282.80 |
| Max. Negotiated Rate |
$404.00 |
| Rate for Payer: AETNA Commercial |
$383.80
|
| Rate for Payer: AETNA Medicare |
$363.60
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$383.80
|
| Rate for Payer: BCBS Healthlink |
$363.60
|
| Rate for Payer: BCBS HMK CHIP |
$363.60
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$363.60
|
| Rate for Payer: BCBS POS |
$383.80
|
| Rate for Payer: BCBS Traditional |
$404.00
|
| Rate for Payer: CASH_PRICE |
$323.20
|
| Rate for Payer: CIGNA Commercial |
$383.80
|
| Rate for Payer: CIGNA Medicare |
$363.60
|
| Rate for Payer: HUMANA Commercial |
$363.60
|
| Rate for Payer: MEDICAID Medicaid |
$371.68
|
| Rate for Payer: MEDICARE Medicare |
$282.80
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$383.80
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$391.88
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$383.80
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$383.80
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$343.40
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$323.20
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$323.20
|
|
|
ER CLOSED DISLOCATION OF THE THUMB
|
Facility
IP
|
$469.00
|
|
|
Service Code
|
CPT 26641
|
| Hospital Charge Code |
20221105
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$328.30 |
| Max. Negotiated Rate |
$469.00 |
| Rate for Payer: AETNA Commercial |
$445.55
|
| Rate for Payer: AETNA Medicare |
$422.10
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$445.55
|
| Rate for Payer: BCBS Healthlink |
$422.10
|
| Rate for Payer: BCBS HMK CHIP |
$422.10
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$422.10
|
| Rate for Payer: BCBS POS |
$445.55
|
| Rate for Payer: BCBS Traditional |
$469.00
|
| Rate for Payer: CASH_PRICE |
$375.20
|
| Rate for Payer: CIGNA Commercial |
$445.55
|
| Rate for Payer: CIGNA Medicare |
$422.10
|
| Rate for Payer: HUMANA Commercial |
$422.10
|
| Rate for Payer: MEDICAID Medicaid |
$431.48
|
| Rate for Payer: MEDICARE Medicare |
$328.30
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$445.55
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$454.93
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$445.55
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$445.55
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$398.65
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$375.20
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$375.20
|
|
|
ER CLOSED DISLOCATION OF THE THUMB
|
Facility
OP
|
$469.00
|
|
|
Service Code
|
CPT 26641
|
| Hospital Charge Code |
20221105
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$328.30 |
| Max. Negotiated Rate |
$469.00 |
| Rate for Payer: AETNA Commercial |
$445.55
|
| Rate for Payer: AETNA Medicare |
$422.10
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$445.55
|
| Rate for Payer: BCBS Healthlink |
$422.10
|
| Rate for Payer: BCBS HMK CHIP |
$422.10
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$422.10
|
| Rate for Payer: BCBS POS |
$445.55
|
| Rate for Payer: BCBS Traditional |
$469.00
|
| Rate for Payer: CASH_PRICE |
$375.20
|
| Rate for Payer: CIGNA Commercial |
$445.55
|
| Rate for Payer: CIGNA Medicare |
$422.10
|
| Rate for Payer: HUMANA Commercial |
$422.10
|
| Rate for Payer: MEDICAID Medicaid |
$431.48
|
| Rate for Payer: MEDICARE Medicare |
$328.30
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$445.55
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$454.93
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$445.55
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$445.55
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$398.65
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$375.20
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$375.20
|
|
|
ER CLOSED FX WRIST WITH MANIPULATION
|
Facility
OP
|
$681.00
|
|
|
Service Code
|
CPT 25505
|
| Hospital Charge Code |
20221105
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$476.70 |
| Max. Negotiated Rate |
$681.00 |
| Rate for Payer: AETNA Commercial |
$646.95
|
| Rate for Payer: AETNA Medicare |
$612.90
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$646.95
|
| Rate for Payer: BCBS Healthlink |
$612.90
|
| Rate for Payer: BCBS HMK CHIP |
$612.90
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$612.90
|
| Rate for Payer: BCBS POS |
$646.95
|
| Rate for Payer: BCBS Traditional |
$681.00
|
| Rate for Payer: CASH_PRICE |
$544.80
|
| Rate for Payer: CIGNA Commercial |
$646.95
|
| Rate for Payer: CIGNA Medicare |
$612.90
|
| Rate for Payer: HUMANA Commercial |
$612.90
|
| Rate for Payer: MEDICAID Medicaid |
$626.52
|
| Rate for Payer: MEDICARE Medicare |
$476.70
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$646.95
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$660.57
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$646.95
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$646.95
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$578.85
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$544.80
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$544.80
|
|
|
ER CLOSED FX WRIST WITH MANIPULATION
|
Facility
IP
|
$681.00
|
|
|
Service Code
|
CPT 25505
|
| Hospital Charge Code |
20221105
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$476.70 |
| Max. Negotiated Rate |
$681.00 |
| Rate for Payer: BCBS HMK CHIP |
$612.90
|
| Rate for Payer: AETNA Commercial |
$646.95
|
| Rate for Payer: AETNA Medicare |
$612.90
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$646.95
|
| Rate for Payer: BCBS Healthlink |
$612.90
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$612.90
|
| Rate for Payer: BCBS POS |
$646.95
|
| Rate for Payer: BCBS Traditional |
$681.00
|
| Rate for Payer: CASH_PRICE |
$544.80
|
| Rate for Payer: CIGNA Commercial |
$646.95
|
| Rate for Payer: CIGNA Medicare |
$612.90
|
| Rate for Payer: HUMANA Commercial |
$612.90
|
| Rate for Payer: MEDICAID Medicaid |
$626.52
|
| Rate for Payer: MEDICARE Medicare |
$476.70
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$646.95
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$660.57
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$646.95
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$646.95
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$578.85
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$544.80
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$544.80
|
|
|
ER CLOSED TX NOSE FX W/O STAB
|
Facility
OP
|
$983.00
|
|
|
Service Code
|
CPT 21315
|
| Hospital Charge Code |
20221105
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$688.10 |
| Max. Negotiated Rate |
$983.00 |
| Rate for Payer: AETNA Commercial |
$933.85
|
| Rate for Payer: AETNA Medicare |
$884.70
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$933.85
|
| Rate for Payer: BCBS Healthlink |
$884.70
|
| Rate for Payer: BCBS HMK CHIP |
$884.70
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$884.70
|
| Rate for Payer: BCBS POS |
$933.85
|
| Rate for Payer: BCBS Traditional |
$983.00
|
| Rate for Payer: CASH_PRICE |
$786.40
|
| Rate for Payer: CIGNA Commercial |
$933.85
|
| Rate for Payer: CIGNA Medicare |
$884.70
|
| Rate for Payer: HUMANA Commercial |
$884.70
|
| Rate for Payer: MEDICAID Medicaid |
$904.36
|
| Rate for Payer: MEDICARE Medicare |
$688.10
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$933.85
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$953.51
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$933.85
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$933.85
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$835.55
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$786.40
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$786.40
|
|
|
ER CLOSED TX NOSE FX W/O STAB
|
Facility
IP
|
$983.00
|
|
|
Service Code
|
CPT 21315
|
| Hospital Charge Code |
20221105
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$688.10 |
| Max. Negotiated Rate |
$983.00 |
| Rate for Payer: AETNA Commercial |
$933.85
|
| Rate for Payer: AETNA Medicare |
$884.70
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$933.85
|
| Rate for Payer: BCBS Healthlink |
$884.70
|
| Rate for Payer: BCBS HMK CHIP |
$884.70
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$884.70
|
| Rate for Payer: BCBS POS |
$933.85
|
| Rate for Payer: BCBS Traditional |
$983.00
|
| Rate for Payer: CASH_PRICE |
$786.40
|
| Rate for Payer: CIGNA Commercial |
$933.85
|
| Rate for Payer: CIGNA Medicare |
$884.70
|
| Rate for Payer: HUMANA Commercial |
$884.70
|
| Rate for Payer: MEDICAID Medicaid |
$904.36
|
| Rate for Payer: MEDICARE Medicare |
$688.10
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$933.85
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$953.51
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$933.85
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$933.85
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$835.55
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$786.40
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$786.40
|
|
|
ER CLSD TRT DISLC OF THE FINGER W/MANI
|
Facility
IP
|
$481.00
|
|
|
Service Code
|
CPT 26700
|
| Hospital Charge Code |
20221105
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$336.70 |
| Max. Negotiated Rate |
$481.00 |
| Rate for Payer: BCBS HMK CHIP |
$432.90
|
| Rate for Payer: AETNA Commercial |
$456.95
|
| Rate for Payer: AETNA Medicare |
$432.90
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$456.95
|
| Rate for Payer: BCBS Healthlink |
$432.90
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$432.90
|
| Rate for Payer: BCBS POS |
$456.95
|
| Rate for Payer: BCBS Traditional |
$481.00
|
| Rate for Payer: CASH_PRICE |
$384.80
|
| Rate for Payer: CIGNA Commercial |
$456.95
|
| Rate for Payer: CIGNA Medicare |
$432.90
|
| Rate for Payer: HUMANA Commercial |
$432.90
|
| Rate for Payer: MEDICAID Medicaid |
$442.52
|
| Rate for Payer: MEDICARE Medicare |
$336.70
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$456.95
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$466.57
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$456.95
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$456.95
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$408.85
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$384.80
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$384.80
|
|
|
ER CLSD TRT DISLC OF THE FINGER W/MANI
|
Facility
OP
|
$481.00
|
|
|
Service Code
|
CPT 26700
|
| Hospital Charge Code |
20221105
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$336.70 |
| Max. Negotiated Rate |
$481.00 |
| Rate for Payer: AETNA Commercial |
$456.95
|
| Rate for Payer: AETNA Medicare |
$432.90
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$456.95
|
| Rate for Payer: BCBS Healthlink |
$432.90
|
| Rate for Payer: BCBS HMK CHIP |
$432.90
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$432.90
|
| Rate for Payer: BCBS POS |
$456.95
|
| Rate for Payer: BCBS Traditional |
$481.00
|
| Rate for Payer: CASH_PRICE |
$384.80
|
| Rate for Payer: CIGNA Commercial |
$456.95
|
| Rate for Payer: CIGNA Medicare |
$432.90
|
| Rate for Payer: HUMANA Commercial |
$432.90
|
| Rate for Payer: MEDICAID Medicaid |
$442.52
|
| Rate for Payer: MEDICARE Medicare |
$336.70
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$456.95
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$466.57
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$456.95
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$456.95
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$408.85
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$384.80
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$384.80
|
|
