|
INJECTION, THERAPEUTIC CARPAL TUNNEL
|
Facility
IP
|
$245.00
|
|
|
Service Code
|
CPT 20526
|
| Hospital Charge Code |
20221105
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$171.50 |
| Max. Negotiated Rate |
$245.00 |
| Rate for Payer: BCBS HMK CHIP |
$220.50
|
| Rate for Payer: AETNA Commercial |
$232.75
|
| Rate for Payer: AETNA Medicare |
$220.50
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$232.75
|
| Rate for Payer: BCBS Healthlink |
$220.50
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$220.50
|
| Rate for Payer: BCBS POS |
$232.75
|
| Rate for Payer: BCBS Traditional |
$245.00
|
| Rate for Payer: CASH_PRICE |
$196.00
|
| Rate for Payer: CIGNA Commercial |
$232.75
|
| Rate for Payer: CIGNA Medicare |
$220.50
|
| Rate for Payer: HUMANA Commercial |
$220.50
|
| Rate for Payer: MEDICAID Medicaid |
$225.40
|
| Rate for Payer: MEDICARE Medicare |
$171.50
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$232.75
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$237.65
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$232.75
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$232.75
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$208.25
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$196.00
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$196.00
|
|
|
INJECTION, THERAPEUTIC CARPAL TUNNEL
|
Facility
OP
|
$245.00
|
|
|
Service Code
|
CPT 20526
|
| Hospital Charge Code |
20221105
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$171.50 |
| Max. Negotiated Rate |
$245.00 |
| Rate for Payer: AETNA Commercial |
$232.75
|
| Rate for Payer: AETNA Medicare |
$220.50
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$232.75
|
| Rate for Payer: BCBS Healthlink |
$220.50
|
| Rate for Payer: BCBS HMK CHIP |
$220.50
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$220.50
|
| Rate for Payer: BCBS POS |
$232.75
|
| Rate for Payer: BCBS Traditional |
$245.00
|
| Rate for Payer: CASH_PRICE |
$196.00
|
| Rate for Payer: CIGNA Commercial |
$232.75
|
| Rate for Payer: CIGNA Medicare |
$220.50
|
| Rate for Payer: HUMANA Commercial |
$220.50
|
| Rate for Payer: MEDICAID Medicaid |
$225.40
|
| Rate for Payer: MEDICARE Medicare |
$171.50
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$232.75
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$237.65
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$232.75
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$232.75
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$208.25
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$196.00
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$196.00
|
|
|
INJECT SINGLE TENDON
|
Facility
OP
|
$312.00
|
|
|
Service Code
|
CPT 20550
|
| Hospital Charge Code |
20221105
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$218.40 |
| Max. Negotiated Rate |
$312.00 |
| Rate for Payer: AETNA Commercial |
$296.40
|
| Rate for Payer: AETNA Medicare |
$280.80
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$296.40
|
| Rate for Payer: BCBS Healthlink |
$280.80
|
| Rate for Payer: BCBS HMK CHIP |
$280.80
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$280.80
|
| Rate for Payer: BCBS POS |
$296.40
|
| Rate for Payer: BCBS Traditional |
$312.00
|
| Rate for Payer: CASH_PRICE |
$249.60
|
| Rate for Payer: CIGNA Commercial |
$296.40
|
| Rate for Payer: CIGNA Medicare |
$280.80
|
| Rate for Payer: HUMANA Commercial |
$280.80
|
| Rate for Payer: MEDICAID Medicaid |
$287.04
|
| Rate for Payer: MEDICARE Medicare |
$218.40
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$296.40
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$302.64
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$296.40
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$296.40
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$265.20
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$249.60
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$249.60
|
|
|
INJECT SINGLE TENDON
|
Facility
IP
|
$312.00
|
|
|
Service Code
|
CPT 20550
|
| Hospital Charge Code |
20221105
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$218.40 |
| Max. Negotiated Rate |
$312.00 |
| Rate for Payer: AETNA Commercial |
$296.40
|
| Rate for Payer: AETNA Medicare |
$280.80
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$296.40
|
| Rate for Payer: BCBS Healthlink |
$280.80
|
| Rate for Payer: BCBS HMK CHIP |
$280.80
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$280.80
|
| Rate for Payer: BCBS POS |
$296.40
|
| Rate for Payer: BCBS Traditional |
$312.00
|
| Rate for Payer: CASH_PRICE |
$249.60
|
| Rate for Payer: CIGNA Commercial |
$296.40
|
| Rate for Payer: CIGNA Medicare |
$280.80
|
| Rate for Payer: HUMANA Commercial |
$280.80
|
| Rate for Payer: MEDICAID Medicaid |
$287.04
|
| Rate for Payer: MEDICARE Medicare |
$218.40
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$296.40
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$302.64
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$296.40
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$296.40
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$265.20
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$249.60
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$249.60
|
|
|
INJ INTRALESIONAL, MORE THAN 7 LESIONS
|
Facility
IP
|
$182.00
|
|
|
Service Code
|
CPT 11901
|
| Hospital Charge Code |
20221105
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$127.40 |
| Max. Negotiated Rate |
$182.00 |
| Rate for Payer: BCBS HMK CHIP |
$163.80
|
| Rate for Payer: AETNA Commercial |
$172.90
|
| Rate for Payer: AETNA Medicare |
$163.80
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$172.90
|
| Rate for Payer: BCBS Healthlink |
$163.80
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$163.80
|
| Rate for Payer: BCBS POS |
$172.90
|
| Rate for Payer: BCBS Traditional |
$182.00
|
| Rate for Payer: CASH_PRICE |
$145.60
|
| Rate for Payer: CIGNA Commercial |
$172.90
|
| Rate for Payer: CIGNA Medicare |
$163.80
|
| Rate for Payer: HUMANA Commercial |
$163.80
|
| Rate for Payer: MEDICAID Medicaid |
$167.44
|
| Rate for Payer: MEDICARE Medicare |
$127.40
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$172.90
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$176.54
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$172.90
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$172.90
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$154.70
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$145.60
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$145.60
|
|
|
INJ INTRALESIONAL, MORE THAN 7 LESIONS
|
Facility
OP
|
$182.00
|
|
|
Service Code
|
CPT 11901
|
| Hospital Charge Code |
20221105
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$127.40 |
| Max. Negotiated Rate |
$182.00 |
| Rate for Payer: AETNA Commercial |
$172.90
|
| Rate for Payer: AETNA Medicare |
$163.80
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$172.90
|
| Rate for Payer: BCBS Healthlink |
$163.80
|
| Rate for Payer: BCBS HMK CHIP |
$163.80
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$163.80
|
| Rate for Payer: BCBS POS |
$172.90
|
| Rate for Payer: BCBS Traditional |
$182.00
|
| Rate for Payer: CASH_PRICE |
$145.60
|
| Rate for Payer: CIGNA Commercial |
$172.90
|
| Rate for Payer: CIGNA Medicare |
$163.80
|
| Rate for Payer: HUMANA Commercial |
$163.80
|
| Rate for Payer: MEDICAID Medicaid |
$167.44
|
| Rate for Payer: MEDICARE Medicare |
$127.40
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$172.90
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$176.54
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$172.90
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$172.90
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$154.70
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$145.60
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$145.60
|
|
|
INJ INTRALESIONAL, UP TO 7 LESIONS
|
Facility
OP
|
$172.00
|
|
|
Service Code
|
CPT 11900
|
| Hospital Charge Code |
20221105
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$120.40 |
| Max. Negotiated Rate |
$172.00 |
| Rate for Payer: AETNA Commercial |
$163.40
|
| Rate for Payer: AETNA Medicare |
$154.80
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$163.40
|
| Rate for Payer: BCBS Healthlink |
$154.80
|
| Rate for Payer: BCBS HMK CHIP |
$154.80
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$154.80
|
| Rate for Payer: BCBS POS |
$163.40
|
| Rate for Payer: BCBS Traditional |
$172.00
|
| Rate for Payer: CASH_PRICE |
$137.60
|
| Rate for Payer: CIGNA Commercial |
$163.40
|
| Rate for Payer: CIGNA Medicare |
$154.80
|
| Rate for Payer: HUMANA Commercial |
$154.80
|
| Rate for Payer: MEDICAID Medicaid |
$158.24
|
| Rate for Payer: MEDICARE Medicare |
$120.40
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$163.40
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$166.84
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$163.40
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$163.40
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$146.20
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$137.60
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$137.60
|
|
|
INJ INTRALESIONAL, UP TO 7 LESIONS
|
Facility
IP
|
$172.00
|
|
|
Service Code
|
CPT 11900
|
| Hospital Charge Code |
20221105
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$120.40 |
| Max. Negotiated Rate |
$172.00 |
| Rate for Payer: AETNA Commercial |
$163.40
|
| Rate for Payer: AETNA Medicare |
$154.80
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$163.40
|
| Rate for Payer: BCBS Healthlink |
$154.80
|
| Rate for Payer: BCBS HMK CHIP |
$154.80
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$154.80
|
| Rate for Payer: BCBS POS |
$163.40
|
| Rate for Payer: BCBS Traditional |
$172.00
|
| Rate for Payer: CASH_PRICE |
$137.60
|
| Rate for Payer: CIGNA Commercial |
$163.40
|
| Rate for Payer: CIGNA Medicare |
$154.80
|
| Rate for Payer: HUMANA Commercial |
$154.80
|
| Rate for Payer: MEDICAID Medicaid |
$158.24
|
| Rate for Payer: MEDICARE Medicare |
$120.40
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$163.40
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$166.84
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$163.40
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$163.40
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$146.20
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$137.60
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$137.60
|
|
|
INJ IPV
|
Facility
IP
|
$47.00
|
|
|
Service Code
|
CPT 90713
|
| Hospital Charge Code |
20221105
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$32.90 |
| Max. Negotiated Rate |
$47.00 |
| Rate for Payer: BCBS HMK CHIP |
$42.30
|
| Rate for Payer: AETNA Commercial |
$44.65
|
| Rate for Payer: AETNA Medicare |
$42.30
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$44.65
|
| Rate for Payer: BCBS Healthlink |
$42.30
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$42.30
|
| Rate for Payer: BCBS POS |
$44.65
|
| Rate for Payer: BCBS Traditional |
$47.00
|
| Rate for Payer: CASH_PRICE |
$37.60
|
| Rate for Payer: CIGNA Commercial |
$44.65
|
| Rate for Payer: CIGNA Medicare |
$42.30
|
| Rate for Payer: HUMANA Commercial |
$42.30
|
| Rate for Payer: MEDICAID Medicaid |
$43.24
|
| Rate for Payer: MEDICARE Medicare |
$32.90
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$44.65
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$45.59
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$44.65
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$44.65
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$39.95
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$37.60
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$37.60
|
|
|
INJ IPV
|
Facility
OP
|
$47.00
|
|
|
Service Code
|
CPT 90713
|
| Hospital Charge Code |
20221105
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$32.90 |
| Max. Negotiated Rate |
$47.00 |
| Rate for Payer: AETNA Commercial |
$44.65
|
| Rate for Payer: AETNA Medicare |
$42.30
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$44.65
|
| Rate for Payer: BCBS Healthlink |
$42.30
|
| Rate for Payer: BCBS HMK CHIP |
$42.30
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$42.30
|
| Rate for Payer: BCBS POS |
$44.65
|
| Rate for Payer: BCBS Traditional |
$47.00
|
| Rate for Payer: CASH_PRICE |
$37.60
|
| Rate for Payer: CIGNA Commercial |
$44.65
|
| Rate for Payer: CIGNA Medicare |
$42.30
|
| Rate for Payer: HUMANA Commercial |
$42.30
|
| Rate for Payer: MEDICAID Medicaid |
$43.24
|
| Rate for Payer: MEDICARE Medicare |
$32.90
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$44.65
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$45.59
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$44.65
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$44.65
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$39.95
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$37.60
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$37.60
|
|
|
INJ IV UP TO ONE HR 250-500C
|
Facility
IP
|
$5.00
|
|
|
Service Code
|
CPT 90780
|
| Hospital Charge Code |
20221105
|
|
Hospital Revenue Code
|
521
|
| 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 CLOSED PLAN NETWORK |
$4.75
|
| Rate for Payer: BCBS Healthlink |
$4.50
|
| Rate for Payer: BCBS HMK CHIP |
$4.50
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$4.50
|
| Rate for Payer: BCBS POS |
$4.75
|
| Rate for Payer: BCBS Traditional |
$5.00
|
| Rate for Payer: CASH_PRICE |
$4.00
|
| Rate for Payer: CIGNA Commercial |
$4.75
|
| Rate for Payer: CIGNA Medicare |
$4.50
|
| Rate for Payer: HUMANA Commercial |
$4.50
|
| Rate for Payer: MEDICAID Medicaid |
$4.60
|
| Rate for Payer: MEDICARE Medicare |
$3.50
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$4.75
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$4.85
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$4.75
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$4.75
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$4.25
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$4.00
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$4.00
|
|
|
INJ IV UP TO ONE HR 250-500C
|
Facility
OP
|
$5.00
|
|
|
Service Code
|
CPT 90780
|
| Hospital Charge Code |
20221105
|
|
Hospital Revenue Code
|
521
|
| 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 CLOSED PLAN NETWORK |
$4.75
|
| Rate for Payer: BCBS Healthlink |
$4.50
|
| Rate for Payer: BCBS HMK CHIP |
$4.50
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$4.50
|
| Rate for Payer: BCBS POS |
$4.75
|
| Rate for Payer: BCBS Traditional |
$5.00
|
| Rate for Payer: CASH_PRICE |
$4.00
|
| Rate for Payer: CIGNA Commercial |
$4.75
|
| Rate for Payer: CIGNA Medicare |
$4.50
|
| Rate for Payer: HUMANA Commercial |
$4.50
|
| Rate for Payer: MEDICAID Medicaid |
$4.60
|
| Rate for Payer: MEDICARE Medicare |
$3.50
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$4.75
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$4.85
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$4.75
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$4.75
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$4.25
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$4.00
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$4.00
|
|
|
INJ SQ/IM NURSE ONLY
|
Facility
OP
|
$92.00
|
|
|
Service Code
|
CPT 96372
|
| Hospital Charge Code |
20221105
|
|
Hospital Revenue Code
|
260
|
| 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
|
|
|
INJ SQ/IM NURSE ONLY
|
Facility
IP
|
$92.00
|
|
|
Service Code
|
CPT 96372
|
| Hospital Charge Code |
20221105
|
|
Hospital Revenue Code
|
260
|
| 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
|
|
|
INSERT DEVICE CENTRAL VENOUS W/PORT >5YR
|
Facility
IP
|
$4,825.00
|
|
|
Service Code
|
CPT 36561
|
| Hospital Charge Code |
20221105
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$3,377.50 |
| Max. Negotiated Rate |
$4,825.00 |
| Rate for Payer: AETNA Commercial |
$4,583.75
|
| Rate for Payer: AETNA Medicare |
$4,342.50
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$4,583.75
|
| Rate for Payer: BCBS Healthlink |
$4,342.50
|
| Rate for Payer: BCBS HMK CHIP |
$4,342.50
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$4,342.50
|
| Rate for Payer: BCBS POS |
$4,583.75
|
| Rate for Payer: BCBS Traditional |
$4,825.00
|
| Rate for Payer: CASH_PRICE |
$3,860.00
|
| Rate for Payer: CIGNA Commercial |
$4,583.75
|
| Rate for Payer: CIGNA Medicare |
$4,342.50
|
| Rate for Payer: HUMANA Commercial |
$4,342.50
|
| Rate for Payer: MEDICAID Medicaid |
$4,439.00
|
| Rate for Payer: MEDICARE Medicare |
$3,377.50
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$4,583.75
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$4,680.25
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$4,583.75
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$4,583.75
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$4,101.25
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$3,860.00
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$3,860.00
|
|
|
INSERT DEVICE CENTRAL VENOUS W/PORT >5YR
|
Facility
OP
|
$4,825.00
|
|
|
Service Code
|
CPT 36561
|
| Hospital Charge Code |
20221105
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$3,377.50 |
| Max. Negotiated Rate |
$4,825.00 |
| Rate for Payer: AETNA Commercial |
$4,583.75
|
| Rate for Payer: AETNA Medicare |
$4,342.50
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$4,583.75
|
| Rate for Payer: BCBS Healthlink |
$4,342.50
|
| Rate for Payer: BCBS HMK CHIP |
$4,342.50
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$4,342.50
|
| Rate for Payer: BCBS POS |
$4,583.75
|
| Rate for Payer: BCBS Traditional |
$4,825.00
|
| Rate for Payer: CASH_PRICE |
$3,860.00
|
| Rate for Payer: CIGNA Commercial |
$4,583.75
|
| Rate for Payer: CIGNA Medicare |
$4,342.50
|
| Rate for Payer: HUMANA Commercial |
$4,342.50
|
| Rate for Payer: MEDICAID Medicaid |
$4,439.00
|
| Rate for Payer: MEDICARE Medicare |
$3,377.50
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$4,583.75
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$4,680.25
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$4,583.75
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$4,583.75
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$4,101.25
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$3,860.00
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$3,860.00
|
|
|
INSERTION OF PICC LINE
|
Facility
IP
|
$1,802.00
|
|
|
Service Code
|
CPT 36569
|
| Hospital Charge Code |
20221105
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,261.40 |
| Max. Negotiated Rate |
$1,802.00 |
| Rate for Payer: BCBS HMK CHIP |
$1,621.80
|
| Rate for Payer: AETNA Commercial |
$1,711.90
|
| Rate for Payer: AETNA Medicare |
$1,621.80
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$1,711.90
|
| Rate for Payer: BCBS Healthlink |
$1,621.80
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$1,621.80
|
| Rate for Payer: BCBS POS |
$1,711.90
|
| Rate for Payer: BCBS Traditional |
$1,802.00
|
| Rate for Payer: CASH_PRICE |
$1,441.60
|
| Rate for Payer: CIGNA Commercial |
$1,711.90
|
| Rate for Payer: CIGNA Medicare |
$1,621.80
|
| Rate for Payer: HUMANA Commercial |
$1,621.80
|
| Rate for Payer: MEDICAID Medicaid |
$1,657.84
|
| Rate for Payer: MEDICARE Medicare |
$1,261.40
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$1,711.90
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$1,747.94
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$1,711.90
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$1,711.90
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$1,531.70
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$1,441.60
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$1,441.60
|
|
|
INSERTION OF PICC LINE
|
Facility
OP
|
$1,802.00
|
|
|
Service Code
|
CPT 36569
|
| Hospital Charge Code |
20221105
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,261.40 |
| Max. Negotiated Rate |
$1,802.00 |
| Rate for Payer: AETNA Commercial |
$1,711.90
|
| Rate for Payer: AETNA Medicare |
$1,621.80
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$1,711.90
|
| Rate for Payer: BCBS Healthlink |
$1,621.80
|
| Rate for Payer: BCBS HMK CHIP |
$1,621.80
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$1,621.80
|
| Rate for Payer: BCBS POS |
$1,711.90
|
| Rate for Payer: BCBS Traditional |
$1,802.00
|
| Rate for Payer: CASH_PRICE |
$1,441.60
|
| Rate for Payer: CIGNA Commercial |
$1,711.90
|
| Rate for Payer: CIGNA Medicare |
$1,621.80
|
| Rate for Payer: HUMANA Commercial |
$1,621.80
|
| Rate for Payer: MEDICAID Medicaid |
$1,657.84
|
| Rate for Payer: MEDICARE Medicare |
$1,261.40
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$1,711.90
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$1,747.94
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$1,711.90
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$1,711.90
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$1,531.70
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$1,441.60
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$1,441.60
|
|
|
INS - GLARGINE INJ [1 UNITS/0.01 ML]
|
Facility
OP
|
$6.00
|
|
|
Service Code
|
CPT J1815
|
| Hospital Charge Code |
20221105
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$4.20 |
| Max. Negotiated Rate |
$6.00 |
| Rate for Payer: AETNA Commercial |
$5.70
|
| Rate for Payer: AETNA Medicare |
$5.40
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$5.70
|
| Rate for Payer: BCBS Healthlink |
$5.40
|
| Rate for Payer: BCBS HMK CHIP |
$5.40
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$5.40
|
| Rate for Payer: BCBS POS |
$5.70
|
| Rate for Payer: BCBS Traditional |
$6.00
|
| Rate for Payer: CASH_PRICE |
$4.80
|
| Rate for Payer: CIGNA Commercial |
$5.70
|
| Rate for Payer: CIGNA Medicare |
$5.40
|
| Rate for Payer: HUMANA Commercial |
$5.40
|
| Rate for Payer: MEDICAID Medicaid |
$5.52
|
| Rate for Payer: MEDICARE Medicare |
$4.20
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$5.70
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$5.82
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$5.70
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$5.70
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$5.10
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$4.80
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$4.80
|
|
|
INS - GLARGINE INJ [1 UNITS/0.01 ML]
|
Facility
IP
|
$6.00
|
|
|
Service Code
|
CPT J1815
|
| Hospital Charge Code |
20221105
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$4.20 |
| Max. Negotiated Rate |
$6.00 |
| Rate for Payer: AETNA Commercial |
$5.70
|
| Rate for Payer: AETNA Medicare |
$5.40
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$5.70
|
| Rate for Payer: BCBS Healthlink |
$5.40
|
| Rate for Payer: BCBS HMK CHIP |
$5.40
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$5.40
|
| Rate for Payer: BCBS POS |
$5.70
|
| Rate for Payer: BCBS Traditional |
$6.00
|
| Rate for Payer: CASH_PRICE |
$4.80
|
| Rate for Payer: CIGNA Commercial |
$5.70
|
| Rate for Payer: CIGNA Medicare |
$5.40
|
| Rate for Payer: HUMANA Commercial |
$5.40
|
| Rate for Payer: MEDICAID Medicaid |
$5.52
|
| Rate for Payer: MEDICARE Medicare |
$4.20
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$5.70
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$5.82
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$5.70
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$5.70
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$5.10
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$4.80
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$4.80
|
|
|
INS - LISPRO [1 UN/0.01 ML] MEAL TIME
|
Facility
IP
|
$27.00
|
|
|
Service Code
|
CPT J1817
|
| Hospital Charge Code |
20221105
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$18.90 |
| Max. Negotiated Rate |
$27.00 |
| Rate for Payer: BCBS HMK CHIP |
$24.30
|
| Rate for Payer: AETNA Commercial |
$25.65
|
| Rate for Payer: AETNA Medicare |
$24.30
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$25.65
|
| Rate for Payer: BCBS Healthlink |
$24.30
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$24.30
|
| Rate for Payer: BCBS POS |
$25.65
|
| Rate for Payer: BCBS Traditional |
$27.00
|
| Rate for Payer: CASH_PRICE |
$21.60
|
| Rate for Payer: CIGNA Commercial |
$25.65
|
| Rate for Payer: CIGNA Medicare |
$24.30
|
| Rate for Payer: HUMANA Commercial |
$24.30
|
| Rate for Payer: MEDICAID Medicaid |
$24.84
|
| Rate for Payer: MEDICARE Medicare |
$18.90
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$25.65
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$26.19
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$25.65
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$25.65
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$22.95
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$21.60
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$21.60
|
|
|
INS - LISPRO [1 UN/0.01 ML] MEAL TIME
|
Facility
OP
|
$27.00
|
|
|
Service Code
|
CPT J1817
|
| Hospital Charge Code |
20221105
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$18.90 |
| Max. Negotiated Rate |
$27.00 |
| Rate for Payer: AETNA Commercial |
$25.65
|
| Rate for Payer: AETNA Medicare |
$24.30
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$25.65
|
| Rate for Payer: BCBS Healthlink |
$24.30
|
| Rate for Payer: BCBS HMK CHIP |
$24.30
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$24.30
|
| Rate for Payer: BCBS POS |
$25.65
|
| Rate for Payer: BCBS Traditional |
$27.00
|
| Rate for Payer: CASH_PRICE |
$21.60
|
| Rate for Payer: CIGNA Commercial |
$25.65
|
| Rate for Payer: CIGNA Medicare |
$24.30
|
| Rate for Payer: HUMANA Commercial |
$24.30
|
| Rate for Payer: MEDICAID Medicaid |
$24.84
|
| Rate for Payer: MEDICARE Medicare |
$18.90
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$25.65
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$26.19
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$25.65
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$25.65
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$22.95
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$21.60
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$21.60
|
|
|
INS - NOVOLIN 70/30 MIX [1U/0.01 ML]
|
Facility
IP
|
$5.00
|
|
|
Service Code
|
CPT J1815
|
| Hospital Charge Code |
20221105
|
|
Hospital Revenue Code
|
250
|
| 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 CLOSED PLAN NETWORK |
$4.75
|
| Rate for Payer: BCBS Healthlink |
$4.50
|
| Rate for Payer: BCBS HMK CHIP |
$4.50
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$4.50
|
| Rate for Payer: BCBS POS |
$4.75
|
| Rate for Payer: BCBS Traditional |
$5.00
|
| Rate for Payer: CASH_PRICE |
$4.00
|
| Rate for Payer: CIGNA Commercial |
$4.75
|
| Rate for Payer: CIGNA Medicare |
$4.50
|
| Rate for Payer: HUMANA Commercial |
$4.50
|
| Rate for Payer: MEDICAID Medicaid |
$4.60
|
| Rate for Payer: MEDICARE Medicare |
$3.50
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$4.75
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$4.85
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$4.75
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$4.75
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$4.25
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$4.00
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$4.00
|
|
|
INS - NOVOLIN 70/30 MIX [1U/0.01 ML]
|
Facility
OP
|
$5.00
|
|
|
Service Code
|
CPT J1815
|
| Hospital Charge Code |
20221105
|
|
Hospital Revenue Code
|
250
|
| 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 CLOSED PLAN NETWORK |
$4.75
|
| Rate for Payer: BCBS Healthlink |
$4.50
|
| Rate for Payer: BCBS HMK CHIP |
$4.50
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$4.50
|
| Rate for Payer: BCBS POS |
$4.75
|
| Rate for Payer: BCBS Traditional |
$5.00
|
| Rate for Payer: CASH_PRICE |
$4.00
|
| Rate for Payer: CIGNA Commercial |
$4.75
|
| Rate for Payer: CIGNA Medicare |
$4.50
|
| Rate for Payer: HUMANA Commercial |
$4.50
|
| Rate for Payer: MEDICAID Medicaid |
$4.60
|
| Rate for Payer: MEDICARE Medicare |
$3.50
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$4.75
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$4.85
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$4.75
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$4.75
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$4.25
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$4.00
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$4.00
|
|
|
INS - NOVOLIN NPH [1 UNITS/0.01 ML]
|
Facility
IP
|
$5.00
|
|
|
Service Code
|
CPT J1815
|
| Hospital Charge Code |
20221105
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$3.50 |
| Max. Negotiated Rate |
$5.00 |
| Rate for Payer: BCBS HMK CHIP |
$4.50
|
| Rate for Payer: AETNA Commercial |
$4.75
|
| Rate for Payer: AETNA Medicare |
$4.50
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$4.75
|
| Rate for Payer: BCBS Healthlink |
$4.50
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$4.50
|
| Rate for Payer: BCBS POS |
$4.75
|
| Rate for Payer: BCBS Traditional |
$5.00
|
| Rate for Payer: CASH_PRICE |
$4.00
|
| Rate for Payer: CIGNA Commercial |
$4.75
|
| Rate for Payer: CIGNA Medicare |
$4.50
|
| Rate for Payer: HUMANA Commercial |
$4.50
|
| Rate for Payer: MEDICAID Medicaid |
$4.60
|
| Rate for Payer: MEDICARE Medicare |
$3.50
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$4.75
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$4.85
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$4.75
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$4.75
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$4.25
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$4.00
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$4.00
|
|
