|
ER CLTX OF FRAC OF THE FINGER EACH W/WO
|
Facility
OP
|
$503.00
|
|
|
Service Code
|
CPT 26725
|
| Hospital Charge Code |
20221105
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$352.10 |
| Max. Negotiated Rate |
$503.00 |
| Rate for Payer: AETNA Commercial |
$477.85
|
| Rate for Payer: AETNA Medicare |
$452.70
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$477.85
|
| Rate for Payer: BCBS Healthlink |
$452.70
|
| Rate for Payer: BCBS HMK CHIP |
$452.70
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$452.70
|
| Rate for Payer: BCBS POS |
$477.85
|
| Rate for Payer: BCBS Traditional |
$503.00
|
| Rate for Payer: CASH_PRICE |
$402.40
|
| Rate for Payer: CIGNA Commercial |
$477.85
|
| Rate for Payer: CIGNA Medicare |
$452.70
|
| Rate for Payer: HUMANA Commercial |
$452.70
|
| Rate for Payer: MEDICAID Medicaid |
$462.76
|
| Rate for Payer: MEDICARE Medicare |
$352.10
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$477.85
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$487.91
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$477.85
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$477.85
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$427.55
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$402.40
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$402.40
|
|
|
ER CLTX OF FRAC OF THE FINGER EACH W/WO
|
Facility
IP
|
$503.00
|
|
|
Service Code
|
CPT 26725
|
| Hospital Charge Code |
20221105
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$352.10 |
| Max. Negotiated Rate |
$503.00 |
| Rate for Payer: AETNA Commercial |
$477.85
|
| Rate for Payer: AETNA Medicare |
$452.70
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$477.85
|
| Rate for Payer: BCBS Healthlink |
$452.70
|
| Rate for Payer: BCBS HMK CHIP |
$452.70
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$452.70
|
| Rate for Payer: BCBS POS |
$477.85
|
| Rate for Payer: BCBS Traditional |
$503.00
|
| Rate for Payer: CASH_PRICE |
$402.40
|
| Rate for Payer: CIGNA Commercial |
$477.85
|
| Rate for Payer: CIGNA Medicare |
$452.70
|
| Rate for Payer: HUMANA Commercial |
$452.70
|
| Rate for Payer: MEDICAID Medicaid |
$462.76
|
| Rate for Payer: MEDICARE Medicare |
$352.10
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$477.85
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$487.91
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$477.85
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$477.85
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$427.55
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$402.40
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$402.40
|
|
|
ER DRAINAGE OF BARTHOLINS GLAND ABSCESS
|
Facility
OP
|
$416.00
|
|
|
Service Code
|
CPT 56420
|
| Hospital Charge Code |
20221105
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$291.20 |
| Max. Negotiated Rate |
$416.00 |
| Rate for Payer: AETNA Commercial |
$395.20
|
| Rate for Payer: AETNA Medicare |
$374.40
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$395.20
|
| Rate for Payer: BCBS Healthlink |
$374.40
|
| Rate for Payer: BCBS HMK CHIP |
$374.40
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$374.40
|
| Rate for Payer: BCBS POS |
$395.20
|
| Rate for Payer: BCBS Traditional |
$416.00
|
| Rate for Payer: CASH_PRICE |
$332.80
|
| Rate for Payer: CIGNA Commercial |
$395.20
|
| Rate for Payer: CIGNA Medicare |
$374.40
|
| Rate for Payer: HUMANA Commercial |
$374.40
|
| Rate for Payer: MEDICAID Medicaid |
$382.72
|
| Rate for Payer: MEDICARE Medicare |
$291.20
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$395.20
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$403.52
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$395.20
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$395.20
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$353.60
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$332.80
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$332.80
|
|
|
ER DRAINAGE OF BARTHOLINS GLAND ABSCESS
|
Facility
IP
|
$416.00
|
|
|
Service Code
|
CPT 56420
|
| Hospital Charge Code |
20221105
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$291.20 |
| Max. Negotiated Rate |
$416.00 |
| Rate for Payer: AETNA Commercial |
$395.20
|
| Rate for Payer: AETNA Medicare |
$374.40
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$395.20
|
| Rate for Payer: BCBS Healthlink |
$374.40
|
| Rate for Payer: BCBS HMK CHIP |
$374.40
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$374.40
|
| Rate for Payer: BCBS POS |
$395.20
|
| Rate for Payer: BCBS Traditional |
$416.00
|
| Rate for Payer: CASH_PRICE |
$332.80
|
| Rate for Payer: CIGNA Commercial |
$395.20
|
| Rate for Payer: CIGNA Medicare |
$374.40
|
| Rate for Payer: HUMANA Commercial |
$374.40
|
| Rate for Payer: MEDICAID Medicaid |
$382.72
|
| Rate for Payer: MEDICARE Medicare |
$291.20
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$395.20
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$403.52
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$395.20
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$395.20
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$353.60
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$332.80
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$332.80
|
|
|
ER DRAIN BLOOD FROM UNDER NAIL
|
Facility
IP
|
$165.00
|
|
|
Service Code
|
CPT 11740
|
| Hospital Charge Code |
20221105
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$115.50 |
| Max. Negotiated Rate |
$165.00 |
| Rate for Payer: BCBS HMK CHIP |
$148.50
|
| Rate for Payer: AETNA Commercial |
$156.75
|
| Rate for Payer: AETNA Medicare |
$148.50
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$156.75
|
| Rate for Payer: BCBS Healthlink |
$148.50
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$148.50
|
| Rate for Payer: BCBS POS |
$156.75
|
| Rate for Payer: BCBS Traditional |
$165.00
|
| Rate for Payer: CASH_PRICE |
$132.00
|
| Rate for Payer: CIGNA Commercial |
$156.75
|
| Rate for Payer: CIGNA Medicare |
$148.50
|
| Rate for Payer: HUMANA Commercial |
$148.50
|
| Rate for Payer: MEDICAID Medicaid |
$151.80
|
| Rate for Payer: MEDICARE Medicare |
$115.50
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$156.75
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$160.05
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$156.75
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$156.75
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$140.25
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$132.00
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$132.00
|
|
|
ER DRAIN BLOOD FROM UNDER NAIL
|
Facility
OP
|
$165.00
|
|
|
Service Code
|
CPT 11740
|
| Hospital Charge Code |
20221105
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$115.50 |
| Max. Negotiated Rate |
$165.00 |
| Rate for Payer: AETNA Commercial |
$156.75
|
| Rate for Payer: AETNA Medicare |
$148.50
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$156.75
|
| Rate for Payer: BCBS Healthlink |
$148.50
|
| Rate for Payer: BCBS HMK CHIP |
$148.50
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$148.50
|
| Rate for Payer: BCBS POS |
$156.75
|
| Rate for Payer: BCBS Traditional |
$165.00
|
| Rate for Payer: CASH_PRICE |
$132.00
|
| Rate for Payer: CIGNA Commercial |
$156.75
|
| Rate for Payer: CIGNA Medicare |
$148.50
|
| Rate for Payer: HUMANA Commercial |
$148.50
|
| Rate for Payer: MEDICAID Medicaid |
$151.80
|
| Rate for Payer: MEDICARE Medicare |
$115.50
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$156.75
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$160.05
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$156.75
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$156.75
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$140.25
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$132.00
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$132.00
|
|
|
ER DRESS/DEBRIDE BURN >10%TOTAL LARGE
|
Facility
IP
|
$495.00
|
|
|
Service Code
|
CPT 16030
|
| Hospital Charge Code |
20221105
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$346.50 |
| Max. Negotiated Rate |
$495.00 |
| Rate for Payer: BCBS HMK CHIP |
$445.50
|
| Rate for Payer: AETNA Commercial |
$470.25
|
| Rate for Payer: AETNA Medicare |
$445.50
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$470.25
|
| Rate for Payer: BCBS Healthlink |
$445.50
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$445.50
|
| Rate for Payer: BCBS POS |
$470.25
|
| Rate for Payer: BCBS Traditional |
$495.00
|
| Rate for Payer: CASH_PRICE |
$396.00
|
| Rate for Payer: CIGNA Commercial |
$470.25
|
| Rate for Payer: CIGNA Medicare |
$445.50
|
| Rate for Payer: HUMANA Commercial |
$445.50
|
| Rate for Payer: MEDICAID Medicaid |
$455.40
|
| Rate for Payer: MEDICARE Medicare |
$346.50
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$470.25
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$480.15
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$470.25
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$470.25
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$420.75
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$396.00
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$396.00
|
|
|
ER DRESS/DEBRIDE BURN >10%TOTAL LARGE
|
Facility
OP
|
$495.00
|
|
|
Service Code
|
CPT 16030
|
| Hospital Charge Code |
20221105
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$346.50 |
| Max. Negotiated Rate |
$495.00 |
| Rate for Payer: AETNA Commercial |
$470.25
|
| Rate for Payer: AETNA Medicare |
$445.50
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$470.25
|
| Rate for Payer: BCBS Healthlink |
$445.50
|
| Rate for Payer: BCBS HMK CHIP |
$445.50
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$445.50
|
| Rate for Payer: BCBS POS |
$470.25
|
| Rate for Payer: BCBS Traditional |
$495.00
|
| Rate for Payer: CASH_PRICE |
$396.00
|
| Rate for Payer: CIGNA Commercial |
$470.25
|
| Rate for Payer: CIGNA Medicare |
$445.50
|
| Rate for Payer: HUMANA Commercial |
$445.50
|
| Rate for Payer: MEDICAID Medicaid |
$455.40
|
| Rate for Payer: MEDICARE Medicare |
$346.50
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$470.25
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$480.15
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$470.25
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$470.25
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$420.75
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$396.00
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$396.00
|
|
|
ER DRESS/DEBRIDE PART-THICK BURNS >5%
|
Facility
IP
|
$365.00
|
|
|
Service Code
|
CPT 16020
|
| Hospital Charge Code |
20221105
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$255.50 |
| Max. Negotiated Rate |
$365.00 |
| Rate for Payer: AETNA Commercial |
$346.75
|
| Rate for Payer: AETNA Medicare |
$328.50
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$346.75
|
| Rate for Payer: BCBS Healthlink |
$328.50
|
| Rate for Payer: BCBS HMK CHIP |
$328.50
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$328.50
|
| Rate for Payer: BCBS POS |
$346.75
|
| Rate for Payer: BCBS Traditional |
$365.00
|
| Rate for Payer: CASH_PRICE |
$292.00
|
| Rate for Payer: CIGNA Commercial |
$346.75
|
| Rate for Payer: CIGNA Medicare |
$328.50
|
| Rate for Payer: HUMANA Commercial |
$328.50
|
| Rate for Payer: MEDICAID Medicaid |
$335.80
|
| Rate for Payer: MEDICARE Medicare |
$255.50
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$346.75
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$354.05
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$346.75
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$346.75
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$310.25
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$292.00
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$292.00
|
|
|
ER DRESS/DEBRIDE PART-THICK BURNS >5%
|
Facility
OP
|
$365.00
|
|
|
Service Code
|
CPT 16020
|
| Hospital Charge Code |
20221105
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$255.50 |
| Max. Negotiated Rate |
$365.00 |
| Rate for Payer: AETNA Commercial |
$346.75
|
| Rate for Payer: AETNA Medicare |
$328.50
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$346.75
|
| Rate for Payer: BCBS Healthlink |
$328.50
|
| Rate for Payer: BCBS HMK CHIP |
$328.50
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$328.50
|
| Rate for Payer: BCBS POS |
$346.75
|
| Rate for Payer: BCBS Traditional |
$365.00
|
| Rate for Payer: CASH_PRICE |
$292.00
|
| Rate for Payer: CIGNA Commercial |
$346.75
|
| Rate for Payer: CIGNA Medicare |
$328.50
|
| Rate for Payer: HUMANA Commercial |
$328.50
|
| Rate for Payer: MEDICAID Medicaid |
$335.80
|
| Rate for Payer: MEDICARE Medicare |
$255.50
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$346.75
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$354.05
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$346.75
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$346.75
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$310.25
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$292.00
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$292.00
|
|
|
ER GASTRIC INTUBATION
|
Facility
OP
|
$353.00
|
|
|
Service Code
|
CPT 43753
|
| Hospital Charge Code |
20221105
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$247.10 |
| Max. Negotiated Rate |
$353.00 |
| Rate for Payer: AETNA Commercial |
$335.35
|
| Rate for Payer: AETNA Medicare |
$317.70
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$335.35
|
| Rate for Payer: BCBS Healthlink |
$317.70
|
| Rate for Payer: BCBS HMK CHIP |
$317.70
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$317.70
|
| Rate for Payer: BCBS POS |
$335.35
|
| Rate for Payer: BCBS Traditional |
$353.00
|
| Rate for Payer: CASH_PRICE |
$282.40
|
| Rate for Payer: CIGNA Commercial |
$335.35
|
| Rate for Payer: CIGNA Medicare |
$317.70
|
| Rate for Payer: HUMANA Commercial |
$317.70
|
| Rate for Payer: MEDICAID Medicaid |
$324.76
|
| Rate for Payer: MEDICARE Medicare |
$247.10
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$335.35
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$342.41
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$335.35
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$335.35
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$300.05
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$282.40
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$282.40
|
|
|
ER GASTRIC INTUBATION
|
Facility
IP
|
$353.00
|
|
|
Service Code
|
CPT 43753
|
| Hospital Charge Code |
20221105
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$247.10 |
| Max. Negotiated Rate |
$353.00 |
| Rate for Payer: BCBS HMK CHIP |
$317.70
|
| Rate for Payer: AETNA Commercial |
$335.35
|
| Rate for Payer: AETNA Medicare |
$317.70
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$335.35
|
| Rate for Payer: BCBS Healthlink |
$317.70
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$317.70
|
| Rate for Payer: BCBS POS |
$335.35
|
| Rate for Payer: BCBS Traditional |
$353.00
|
| Rate for Payer: CASH_PRICE |
$282.40
|
| Rate for Payer: CIGNA Commercial |
$335.35
|
| Rate for Payer: CIGNA Medicare |
$317.70
|
| Rate for Payer: HUMANA Commercial |
$317.70
|
| Rate for Payer: MEDICAID Medicaid |
$324.76
|
| Rate for Payer: MEDICARE Medicare |
$247.10
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$335.35
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$342.41
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$335.35
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$335.35
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$300.05
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$282.40
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$282.40
|
|
|
ER INCISION OF RECTAL ABSCESS
|
Facility
IP
|
$983.00
|
|
|
Service Code
|
CPT 46040
|
| 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 INCISION OF RECTAL ABSCESS
|
Facility
OP
|
$983.00
|
|
|
Service Code
|
CPT 46040
|
| 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 INFUSION ADD PUMP SET UP
|
Facility
IP
|
$89.00
|
|
|
Service Code
|
CPT 96371
|
| Hospital Charge Code |
20221105
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$62.30 |
| Max. Negotiated Rate |
$89.00 |
| Rate for Payer: BCBS HMK CHIP |
$80.10
|
| 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 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
|
|
|
ER INFUSION ADD PUMP SET UP
|
Facility
OP
|
$89.00
|
|
|
Service Code
|
CPT 96371
|
| Hospital Charge Code |
20221105
|
|
Hospital Revenue Code
|
450
|
| 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
|
|
|
ER INJ AND/OR ASPIRATION JOINT INTERM
|
Facility
OP
|
$421.00
|
|
|
Service Code
|
CPT 20605
|
| Hospital Charge Code |
20221105
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$294.70 |
| Max. Negotiated Rate |
$421.00 |
| Rate for Payer: AETNA Commercial |
$399.95
|
| Rate for Payer: AETNA Medicare |
$378.90
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$399.95
|
| Rate for Payer: BCBS Healthlink |
$378.90
|
| Rate for Payer: BCBS HMK CHIP |
$378.90
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$378.90
|
| Rate for Payer: BCBS POS |
$399.95
|
| Rate for Payer: BCBS Traditional |
$421.00
|
| Rate for Payer: CASH_PRICE |
$336.80
|
| Rate for Payer: CIGNA Commercial |
$399.95
|
| Rate for Payer: CIGNA Medicare |
$378.90
|
| Rate for Payer: HUMANA Commercial |
$378.90
|
| Rate for Payer: MEDICAID Medicaid |
$387.32
|
| Rate for Payer: MEDICARE Medicare |
$294.70
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$399.95
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$408.37
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$399.95
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$399.95
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$357.85
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$336.80
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$336.80
|
|
|
ER INJ AND/OR ASPIRATION JOINT INTERM
|
Facility
IP
|
$421.00
|
|
|
Service Code
|
CPT 20605
|
| Hospital Charge Code |
20221105
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$294.70 |
| Max. Negotiated Rate |
$421.00 |
| Rate for Payer: AETNA Commercial |
$399.95
|
| Rate for Payer: AETNA Medicare |
$378.90
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$399.95
|
| Rate for Payer: BCBS Healthlink |
$378.90
|
| Rate for Payer: BCBS HMK CHIP |
$378.90
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$378.90
|
| Rate for Payer: BCBS POS |
$399.95
|
| Rate for Payer: BCBS Traditional |
$421.00
|
| Rate for Payer: CASH_PRICE |
$336.80
|
| Rate for Payer: CIGNA Commercial |
$399.95
|
| Rate for Payer: CIGNA Medicare |
$378.90
|
| Rate for Payer: HUMANA Commercial |
$378.90
|
| Rate for Payer: MEDICAID Medicaid |
$387.32
|
| Rate for Payer: MEDICARE Medicare |
$294.70
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$399.95
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$408.37
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$399.95
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$399.95
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$357.85
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$336.80
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$336.80
|
|
|
ER INJECT/ASPIR JOINT LG
|
Facility
OP
|
$599.00
|
|
|
Service Code
|
CPT 20610
|
| Hospital Charge Code |
20221105
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$419.30 |
| Max. Negotiated Rate |
$599.00 |
| Rate for Payer: AETNA Commercial |
$569.05
|
| Rate for Payer: AETNA Medicare |
$539.10
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$569.05
|
| Rate for Payer: BCBS Healthlink |
$539.10
|
| Rate for Payer: BCBS HMK CHIP |
$539.10
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$539.10
|
| Rate for Payer: BCBS POS |
$569.05
|
| Rate for Payer: BCBS Traditional |
$599.00
|
| Rate for Payer: CASH_PRICE |
$479.20
|
| Rate for Payer: CIGNA Commercial |
$569.05
|
| Rate for Payer: CIGNA Medicare |
$539.10
|
| Rate for Payer: HUMANA Commercial |
$539.10
|
| Rate for Payer: MEDICAID Medicaid |
$551.08
|
| Rate for Payer: MEDICARE Medicare |
$419.30
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$569.05
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$581.03
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$569.05
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$569.05
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$509.15
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$479.20
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$479.20
|
|
|
ER INJECT/ASPIR JOINT LG
|
Facility
IP
|
$599.00
|
|
|
Service Code
|
CPT 20610
|
| Hospital Charge Code |
20221105
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$419.30 |
| Max. Negotiated Rate |
$599.00 |
| Rate for Payer: AETNA Commercial |
$569.05
|
| Rate for Payer: AETNA Medicare |
$539.10
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$569.05
|
| Rate for Payer: BCBS Healthlink |
$539.10
|
| Rate for Payer: BCBS HMK CHIP |
$539.10
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$539.10
|
| Rate for Payer: BCBS POS |
$569.05
|
| Rate for Payer: BCBS Traditional |
$599.00
|
| Rate for Payer: CASH_PRICE |
$479.20
|
| Rate for Payer: CIGNA Commercial |
$569.05
|
| Rate for Payer: CIGNA Medicare |
$539.10
|
| Rate for Payer: HUMANA Commercial |
$539.10
|
| Rate for Payer: MEDICAID Medicaid |
$551.08
|
| Rate for Payer: MEDICARE Medicare |
$419.30
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$569.05
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$581.03
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$569.05
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$569.05
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$509.15
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$479.20
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$479.20
|
|
|
ER INJ SQ/IM
|
Facility
IP
|
$92.00
|
|
|
Service Code
|
CPT 96372
|
| Hospital Charge Code |
20221105
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$64.40 |
| Max. Negotiated Rate |
$92.00 |
| Rate for Payer: BCBS HMK CHIP |
$82.80
|
| Rate for Payer: AETNA Commercial |
$87.40
|
| Rate for Payer: AETNA Medicare |
$82.80
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$87.40
|
| Rate for Payer: BCBS Healthlink |
$82.80
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$82.80
|
| Rate for Payer: BCBS POS |
$87.40
|
| Rate for Payer: BCBS Traditional |
$92.00
|
| Rate for Payer: CASH_PRICE |
$73.60
|
| Rate for Payer: CIGNA Commercial |
$87.40
|
| Rate for Payer: CIGNA Medicare |
$82.80
|
| Rate for Payer: HUMANA Commercial |
$82.80
|
| Rate for Payer: MEDICAID Medicaid |
$84.64
|
| Rate for Payer: MEDICARE Medicare |
$64.40
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$87.40
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$89.24
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$87.40
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$87.40
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$78.20
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$73.60
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$73.60
|
|
|
ER INJ SQ/IM
|
Facility
OP
|
$92.00
|
|
|
Service Code
|
CPT 96372
|
| Hospital Charge Code |
20221105
|
|
Hospital Revenue Code
|
450
|
| 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 CLOSED PLAN NETWORK |
$87.40
|
| Rate for Payer: BCBS Healthlink |
$82.80
|
| Rate for Payer: BCBS HMK CHIP |
$82.80
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$82.80
|
| Rate for Payer: BCBS POS |
$87.40
|
| Rate for Payer: BCBS Traditional |
$92.00
|
| Rate for Payer: CASH_PRICE |
$73.60
|
| Rate for Payer: CIGNA Commercial |
$87.40
|
| Rate for Payer: CIGNA Medicare |
$82.80
|
| Rate for Payer: HUMANA Commercial |
$82.80
|
| Rate for Payer: MEDICAID Medicaid |
$84.64
|
| Rate for Payer: MEDICARE Medicare |
$64.40
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$87.40
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$89.24
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$87.40
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$87.40
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$78.20
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$73.60
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$73.60
|
|
|
ER INSERT EMERGENCY AIRWAY
|
Facility
IP
|
$605.00
|
|
|
Service Code
|
CPT 31500
|
| Hospital Charge Code |
20221105
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$423.50 |
| Max. Negotiated Rate |
$605.00 |
| Rate for Payer: BCBS HMK CHIP |
$544.50
|
| Rate for Payer: AETNA Commercial |
$574.75
|
| Rate for Payer: AETNA Medicare |
$544.50
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$574.75
|
| Rate for Payer: BCBS Healthlink |
$544.50
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$544.50
|
| Rate for Payer: BCBS POS |
$574.75
|
| Rate for Payer: BCBS Traditional |
$605.00
|
| Rate for Payer: CASH_PRICE |
$484.00
|
| Rate for Payer: CIGNA Commercial |
$574.75
|
| Rate for Payer: CIGNA Medicare |
$544.50
|
| Rate for Payer: HUMANA Commercial |
$544.50
|
| Rate for Payer: MEDICAID Medicaid |
$556.60
|
| Rate for Payer: MEDICARE Medicare |
$423.50
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$574.75
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$586.85
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$574.75
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$574.75
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$514.25
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$484.00
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$484.00
|
|
|
ER INSERT EMERGENCY AIRWAY
|
Facility
OP
|
$605.00
|
|
|
Service Code
|
CPT 31500
|
| Hospital Charge Code |
20221105
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$423.50 |
| Max. Negotiated Rate |
$605.00 |
| Rate for Payer: AETNA Commercial |
$574.75
|
| Rate for Payer: AETNA Medicare |
$544.50
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$574.75
|
| Rate for Payer: BCBS Healthlink |
$544.50
|
| Rate for Payer: BCBS HMK CHIP |
$544.50
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$544.50
|
| Rate for Payer: BCBS POS |
$574.75
|
| Rate for Payer: BCBS Traditional |
$605.00
|
| Rate for Payer: CASH_PRICE |
$484.00
|
| Rate for Payer: CIGNA Commercial |
$574.75
|
| Rate for Payer: CIGNA Medicare |
$544.50
|
| Rate for Payer: HUMANA Commercial |
$544.50
|
| Rate for Payer: MEDICAID Medicaid |
$556.60
|
| Rate for Payer: MEDICARE Medicare |
$423.50
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$574.75
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$586.85
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$574.75
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$574.75
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$514.25
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$484.00
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$484.00
|
|
|
ER INSERTION OF CHEST TUBE
|
Facility
OP
|
$1,182.00
|
|
|
Service Code
|
CPT 32551
|
| Hospital Charge Code |
20221105
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$827.40 |
| Max. Negotiated Rate |
$1,182.00 |
| Rate for Payer: AETNA Commercial |
$1,122.90
|
| Rate for Payer: AETNA Medicare |
$1,063.80
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$1,122.90
|
| Rate for Payer: BCBS Healthlink |
$1,063.80
|
| Rate for Payer: BCBS HMK CHIP |
$1,063.80
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$1,063.80
|
| Rate for Payer: BCBS POS |
$1,122.90
|
| Rate for Payer: BCBS Traditional |
$1,182.00
|
| Rate for Payer: CASH_PRICE |
$945.60
|
| Rate for Payer: CIGNA Commercial |
$1,122.90
|
| Rate for Payer: CIGNA Medicare |
$1,063.80
|
| Rate for Payer: HUMANA Commercial |
$1,063.80
|
| Rate for Payer: MEDICAID Medicaid |
$1,087.44
|
| Rate for Payer: MEDICARE Medicare |
$827.40
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$1,122.90
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$1,146.54
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$1,122.90
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$1,122.90
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$1,004.70
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$945.60
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$945.60
|
|
