|
LAB ANTIPEROXIDASE AB
|
Facility
IP
|
$71.00
|
|
|
Service Code
|
CPT 84432
|
| Hospital Charge Code |
20211001
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$49.70 |
| Max. Negotiated Rate |
$71.00 |
| Rate for Payer: BCBS HMK CHIP |
$63.90
|
| Rate for Payer: AETNA Commercial |
$67.45
|
| Rate for Payer: AETNA Medicare |
$63.90
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$67.45
|
| Rate for Payer: BCBS Healthlink |
$63.90
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$63.90
|
| Rate for Payer: BCBS POS |
$67.45
|
| Rate for Payer: BCBS Traditional |
$71.00
|
| Rate for Payer: CASH_PRICE |
$56.80
|
| Rate for Payer: CIGNA Commercial |
$67.45
|
| Rate for Payer: CIGNA Medicare |
$63.90
|
| Rate for Payer: HUMANA Commercial |
$63.90
|
| Rate for Payer: MEDICAID Medicaid |
$65.32
|
| Rate for Payer: MEDICARE Medicare |
$49.70
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$67.45
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$68.87
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$67.45
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$67.45
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$60.35
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$56.80
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$56.80
|
|
|
LAB ANTIPEROXIDASE AB
|
Facility
OP
|
$71.00
|
|
|
Service Code
|
CPT 84432
|
| Hospital Charge Code |
20211001
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$49.70 |
| Max. Negotiated Rate |
$71.00 |
| Rate for Payer: AETNA Commercial |
$67.45
|
| Rate for Payer: AETNA Medicare |
$63.90
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$67.45
|
| Rate for Payer: BCBS Healthlink |
$63.90
|
| Rate for Payer: BCBS HMK CHIP |
$63.90
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$63.90
|
| Rate for Payer: BCBS POS |
$67.45
|
| Rate for Payer: BCBS Traditional |
$71.00
|
| Rate for Payer: CASH_PRICE |
$56.80
|
| Rate for Payer: CIGNA Commercial |
$67.45
|
| Rate for Payer: CIGNA Medicare |
$63.90
|
| Rate for Payer: HUMANA Commercial |
$63.90
|
| Rate for Payer: MEDICAID Medicaid |
$65.32
|
| Rate for Payer: MEDICARE Medicare |
$49.70
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$67.45
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$68.87
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$67.45
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$67.45
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$60.35
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$56.80
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$56.80
|
|
|
LAB ARSENIC
|
Facility
OP
|
$78.00
|
|
|
Service Code
|
CPT 82175
|
| Hospital Charge Code |
20211001
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$54.60 |
| Max. Negotiated Rate |
$78.00 |
| Rate for Payer: AETNA Commercial |
$74.10
|
| Rate for Payer: AETNA Medicare |
$70.20
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$74.10
|
| Rate for Payer: BCBS Healthlink |
$70.20
|
| Rate for Payer: BCBS HMK CHIP |
$70.20
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$70.20
|
| Rate for Payer: BCBS POS |
$74.10
|
| Rate for Payer: BCBS Traditional |
$78.00
|
| Rate for Payer: CASH_PRICE |
$62.40
|
| Rate for Payer: CIGNA Commercial |
$74.10
|
| Rate for Payer: CIGNA Medicare |
$70.20
|
| Rate for Payer: HUMANA Commercial |
$70.20
|
| Rate for Payer: MEDICAID Medicaid |
$71.76
|
| Rate for Payer: MEDICARE Medicare |
$54.60
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$74.10
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$75.66
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$74.10
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$74.10
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$66.30
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$62.40
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$62.40
|
|
|
LAB ARSENIC
|
Facility
IP
|
$78.00
|
|
|
Service Code
|
CPT 82175
|
| Hospital Charge Code |
20211001
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$54.60 |
| Max. Negotiated Rate |
$78.00 |
| Rate for Payer: AETNA Commercial |
$74.10
|
| Rate for Payer: AETNA Medicare |
$70.20
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$74.10
|
| Rate for Payer: BCBS Healthlink |
$70.20
|
| Rate for Payer: BCBS HMK CHIP |
$70.20
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$70.20
|
| Rate for Payer: BCBS POS |
$74.10
|
| Rate for Payer: BCBS Traditional |
$78.00
|
| Rate for Payer: CASH_PRICE |
$62.40
|
| Rate for Payer: CIGNA Commercial |
$74.10
|
| Rate for Payer: CIGNA Medicare |
$70.20
|
| Rate for Payer: HUMANA Commercial |
$70.20
|
| Rate for Payer: MEDICAID Medicaid |
$71.76
|
| Rate for Payer: MEDICARE Medicare |
$54.60
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$74.10
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$75.66
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$74.10
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$74.10
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$66.30
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$62.40
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$62.40
|
|
|
LAB ARTERIAL PUNCTURE
|
Facility
OP
|
$84.00
|
|
|
Service Code
|
CPT 36600
|
| Hospital Charge Code |
20211001
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$58.80 |
| Max. Negotiated Rate |
$84.00 |
| Rate for Payer: AETNA Commercial |
$79.80
|
| Rate for Payer: AETNA Medicare |
$75.60
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$79.80
|
| Rate for Payer: BCBS Healthlink |
$75.60
|
| Rate for Payer: BCBS HMK CHIP |
$75.60
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$75.60
|
| Rate for Payer: BCBS POS |
$79.80
|
| Rate for Payer: BCBS Traditional |
$84.00
|
| Rate for Payer: CASH_PRICE |
$67.20
|
| Rate for Payer: CIGNA Commercial |
$79.80
|
| Rate for Payer: CIGNA Medicare |
$75.60
|
| Rate for Payer: HUMANA Commercial |
$75.60
|
| Rate for Payer: MEDICAID Medicaid |
$77.28
|
| Rate for Payer: MEDICARE Medicare |
$58.80
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$79.80
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$81.48
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$79.80
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$79.80
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$71.40
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$67.20
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$67.20
|
|
|
LAB ARTERIAL PUNCTURE
|
Facility
IP
|
$84.00
|
|
|
Service Code
|
CPT 36600
|
| Hospital Charge Code |
20211001
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$58.80 |
| Max. Negotiated Rate |
$84.00 |
| Rate for Payer: BCBS HMK CHIP |
$75.60
|
| Rate for Payer: AETNA Commercial |
$79.80
|
| Rate for Payer: AETNA Medicare |
$75.60
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$79.80
|
| Rate for Payer: BCBS Healthlink |
$75.60
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$75.60
|
| Rate for Payer: BCBS POS |
$79.80
|
| Rate for Payer: BCBS Traditional |
$84.00
|
| Rate for Payer: CASH_PRICE |
$67.20
|
| Rate for Payer: CIGNA Commercial |
$79.80
|
| Rate for Payer: CIGNA Medicare |
$75.60
|
| Rate for Payer: HUMANA Commercial |
$75.60
|
| Rate for Payer: MEDICAID Medicaid |
$77.28
|
| Rate for Payer: MEDICARE Medicare |
$58.80
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$79.80
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$81.48
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$79.80
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$79.80
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$71.40
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$67.20
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$67.20
|
|
|
LAB ASPIRATE - CRYSTAL IDENTIFICATION
|
Facility
IP
|
$59.00
|
|
|
Service Code
|
CPT 89060
|
| Hospital Charge Code |
20211001
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$41.30 |
| Max. Negotiated Rate |
$59.00 |
| Rate for Payer: AETNA Commercial |
$56.05
|
| Rate for Payer: AETNA Medicare |
$53.10
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$56.05
|
| Rate for Payer: BCBS Healthlink |
$53.10
|
| Rate for Payer: BCBS HMK CHIP |
$53.10
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$53.10
|
| Rate for Payer: BCBS POS |
$56.05
|
| Rate for Payer: BCBS Traditional |
$59.00
|
| Rate for Payer: CASH_PRICE |
$47.20
|
| Rate for Payer: CIGNA Commercial |
$56.05
|
| Rate for Payer: CIGNA Medicare |
$53.10
|
| Rate for Payer: HUMANA Commercial |
$53.10
|
| Rate for Payer: MEDICAID Medicaid |
$54.28
|
| Rate for Payer: MEDICARE Medicare |
$41.30
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$56.05
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$57.23
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$56.05
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$56.05
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$50.15
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$47.20
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$47.20
|
|
|
LAB ASPIRATE - CRYSTAL IDENTIFICATION
|
Facility
OP
|
$59.00
|
|
|
Service Code
|
CPT 89060
|
| Hospital Charge Code |
20211001
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$41.30 |
| Max. Negotiated Rate |
$59.00 |
| Rate for Payer: AETNA Commercial |
$56.05
|
| Rate for Payer: AETNA Medicare |
$53.10
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$56.05
|
| Rate for Payer: BCBS Healthlink |
$53.10
|
| Rate for Payer: BCBS HMK CHIP |
$53.10
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$53.10
|
| Rate for Payer: BCBS POS |
$56.05
|
| Rate for Payer: BCBS Traditional |
$59.00
|
| Rate for Payer: CASH_PRICE |
$47.20
|
| Rate for Payer: CIGNA Commercial |
$56.05
|
| Rate for Payer: CIGNA Medicare |
$53.10
|
| Rate for Payer: HUMANA Commercial |
$53.10
|
| Rate for Payer: MEDICAID Medicaid |
$54.28
|
| Rate for Payer: MEDICARE Medicare |
$41.30
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$56.05
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$57.23
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$56.05
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$56.05
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$50.15
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$47.20
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$47.20
|
|
|
LAB BACTERIAL ID
|
Facility
IP
|
$83.00
|
|
|
Service Code
|
CPT 87077
|
| Hospital Charge Code |
20211001
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$58.10 |
| Max. Negotiated Rate |
$83.00 |
| Rate for Payer: BCBS HMK CHIP |
$74.70
|
| Rate for Payer: AETNA Commercial |
$78.85
|
| Rate for Payer: AETNA Medicare |
$74.70
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$78.85
|
| Rate for Payer: BCBS Healthlink |
$74.70
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$74.70
|
| Rate for Payer: BCBS POS |
$78.85
|
| Rate for Payer: BCBS Traditional |
$83.00
|
| Rate for Payer: CASH_PRICE |
$66.40
|
| Rate for Payer: CIGNA Commercial |
$78.85
|
| Rate for Payer: CIGNA Medicare |
$74.70
|
| Rate for Payer: HUMANA Commercial |
$74.70
|
| Rate for Payer: MEDICAID Medicaid |
$76.36
|
| Rate for Payer: MEDICARE Medicare |
$58.10
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$78.85
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$80.51
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$78.85
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$78.85
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$70.55
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$66.40
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$66.40
|
|
|
LAB BACTERIAL ID
|
Facility
OP
|
$83.00
|
|
|
Service Code
|
CPT 87077
|
| Hospital Charge Code |
20211001
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$58.10 |
| Max. Negotiated Rate |
$83.00 |
| Rate for Payer: AETNA Commercial |
$78.85
|
| Rate for Payer: AETNA Medicare |
$74.70
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$78.85
|
| Rate for Payer: BCBS Healthlink |
$74.70
|
| Rate for Payer: BCBS HMK CHIP |
$74.70
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$74.70
|
| Rate for Payer: BCBS POS |
$78.85
|
| Rate for Payer: BCBS Traditional |
$83.00
|
| Rate for Payer: CASH_PRICE |
$66.40
|
| Rate for Payer: CIGNA Commercial |
$78.85
|
| Rate for Payer: CIGNA Medicare |
$74.70
|
| Rate for Payer: HUMANA Commercial |
$74.70
|
| Rate for Payer: MEDICAID Medicaid |
$76.36
|
| Rate for Payer: MEDICARE Medicare |
$58.10
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$78.85
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$80.51
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$78.85
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$78.85
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$70.55
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$66.40
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$66.40
|
|
|
LAB BARTONELLA SEROLOGY
|
Facility
IP
|
$149.00
|
|
|
Service Code
|
CPT 86256
|
| Hospital Charge Code |
20211001
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$104.30 |
| Max. Negotiated Rate |
$149.00 |
| Rate for Payer: AETNA Commercial |
$141.55
|
| Rate for Payer: AETNA Medicare |
$134.10
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$141.55
|
| Rate for Payer: BCBS Healthlink |
$134.10
|
| Rate for Payer: BCBS HMK CHIP |
$134.10
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$134.10
|
| Rate for Payer: BCBS POS |
$141.55
|
| Rate for Payer: BCBS Traditional |
$149.00
|
| Rate for Payer: CASH_PRICE |
$119.20
|
| Rate for Payer: CIGNA Commercial |
$141.55
|
| Rate for Payer: CIGNA Medicare |
$134.10
|
| Rate for Payer: HUMANA Commercial |
$134.10
|
| Rate for Payer: MEDICAID Medicaid |
$137.08
|
| Rate for Payer: MEDICARE Medicare |
$104.30
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$141.55
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$144.53
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$141.55
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$141.55
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$126.65
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$119.20
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$119.20
|
|
|
LAB BARTONELLA SEROLOGY
|
Facility
OP
|
$149.00
|
|
|
Service Code
|
CPT 86256
|
| Hospital Charge Code |
20211001
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$104.30 |
| Max. Negotiated Rate |
$149.00 |
| Rate for Payer: AETNA Commercial |
$141.55
|
| Rate for Payer: AETNA Medicare |
$134.10
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$141.55
|
| Rate for Payer: BCBS Healthlink |
$134.10
|
| Rate for Payer: BCBS HMK CHIP |
$134.10
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$134.10
|
| Rate for Payer: BCBS POS |
$141.55
|
| Rate for Payer: BCBS Traditional |
$149.00
|
| Rate for Payer: CASH_PRICE |
$119.20
|
| Rate for Payer: CIGNA Commercial |
$141.55
|
| Rate for Payer: CIGNA Medicare |
$134.10
|
| Rate for Payer: HUMANA Commercial |
$134.10
|
| Rate for Payer: MEDICAID Medicaid |
$137.08
|
| Rate for Payer: MEDICARE Medicare |
$104.30
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$141.55
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$144.53
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$141.55
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$141.55
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$126.65
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$119.20
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$119.20
|
|
|
LAB BETA LACTAMASE
|
Facility
OP
|
$52.00
|
|
|
Service Code
|
CPT 87185
|
| Hospital Charge Code |
20211001
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$36.40 |
| Max. Negotiated Rate |
$52.00 |
| Rate for Payer: AETNA Commercial |
$49.40
|
| Rate for Payer: AETNA Medicare |
$46.80
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$49.40
|
| Rate for Payer: BCBS Healthlink |
$46.80
|
| Rate for Payer: BCBS HMK CHIP |
$46.80
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$46.80
|
| Rate for Payer: BCBS POS |
$49.40
|
| Rate for Payer: BCBS Traditional |
$52.00
|
| Rate for Payer: CASH_PRICE |
$41.60
|
| Rate for Payer: CIGNA Commercial |
$49.40
|
| Rate for Payer: CIGNA Medicare |
$46.80
|
| Rate for Payer: HUMANA Commercial |
$46.80
|
| Rate for Payer: MEDICAID Medicaid |
$47.84
|
| Rate for Payer: MEDICARE Medicare |
$36.40
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$49.40
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$50.44
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$49.40
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$49.40
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$44.20
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$41.60
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$41.60
|
|
|
LAB BETA LACTAMASE
|
Facility
IP
|
$52.00
|
|
|
Service Code
|
CPT 87185
|
| Hospital Charge Code |
20211001
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$36.40 |
| Max. Negotiated Rate |
$52.00 |
| Rate for Payer: BCBS HMK CHIP |
$46.80
|
| Rate for Payer: AETNA Commercial |
$49.40
|
| Rate for Payer: AETNA Medicare |
$46.80
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$49.40
|
| Rate for Payer: BCBS Healthlink |
$46.80
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$46.80
|
| Rate for Payer: BCBS POS |
$49.40
|
| Rate for Payer: BCBS Traditional |
$52.00
|
| Rate for Payer: CASH_PRICE |
$41.60
|
| Rate for Payer: CIGNA Commercial |
$49.40
|
| Rate for Payer: CIGNA Medicare |
$46.80
|
| Rate for Payer: HUMANA Commercial |
$46.80
|
| Rate for Payer: MEDICAID Medicaid |
$47.84
|
| Rate for Payer: MEDICARE Medicare |
$36.40
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$49.40
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$50.44
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$49.40
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$49.40
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$44.20
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$41.60
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$41.60
|
|
|
LAB BIOTINIDOSE
|
Facility
OP
|
$78.00
|
|
|
Service Code
|
CPT 82261
|
| Hospital Charge Code |
20211001
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$54.60 |
| Max. Negotiated Rate |
$78.00 |
| Rate for Payer: AETNA Commercial |
$74.10
|
| Rate for Payer: AETNA Medicare |
$70.20
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$74.10
|
| Rate for Payer: BCBS Healthlink |
$70.20
|
| Rate for Payer: BCBS HMK CHIP |
$70.20
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$70.20
|
| Rate for Payer: BCBS POS |
$74.10
|
| Rate for Payer: BCBS Traditional |
$78.00
|
| Rate for Payer: CASH_PRICE |
$62.40
|
| Rate for Payer: CIGNA Commercial |
$74.10
|
| Rate for Payer: CIGNA Medicare |
$70.20
|
| Rate for Payer: HUMANA Commercial |
$70.20
|
| Rate for Payer: MEDICAID Medicaid |
$71.76
|
| Rate for Payer: MEDICARE Medicare |
$54.60
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$74.10
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$75.66
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$74.10
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$74.10
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$66.30
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$62.40
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$62.40
|
|
|
LAB BIOTINIDOSE
|
Facility
IP
|
$78.00
|
|
|
Service Code
|
CPT 82261
|
| Hospital Charge Code |
20211001
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$54.60 |
| Max. Negotiated Rate |
$78.00 |
| Rate for Payer: AETNA Commercial |
$74.10
|
| Rate for Payer: AETNA Medicare |
$70.20
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$74.10
|
| Rate for Payer: BCBS Healthlink |
$70.20
|
| Rate for Payer: BCBS HMK CHIP |
$70.20
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$70.20
|
| Rate for Payer: BCBS POS |
$74.10
|
| Rate for Payer: BCBS Traditional |
$78.00
|
| Rate for Payer: CASH_PRICE |
$62.40
|
| Rate for Payer: CIGNA Commercial |
$74.10
|
| Rate for Payer: CIGNA Medicare |
$70.20
|
| Rate for Payer: HUMANA Commercial |
$70.20
|
| Rate for Payer: MEDICAID Medicaid |
$71.76
|
| Rate for Payer: MEDICARE Medicare |
$54.60
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$74.10
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$75.66
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$74.10
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$74.10
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$66.30
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$62.40
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$62.40
|
|
|
LAB BLOOD DRAW FROM IMPLANTED DEVICE
|
Facility
IP
|
$120.00
|
|
|
Service Code
|
CPT 36591
|
| Hospital Charge Code |
20211001
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$84.00 |
| Max. Negotiated Rate |
$120.00 |
| Rate for Payer: BCBS HMK CHIP |
$108.00
|
| Rate for Payer: AETNA Commercial |
$114.00
|
| Rate for Payer: AETNA Medicare |
$108.00
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$114.00
|
| Rate for Payer: BCBS Healthlink |
$108.00
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$108.00
|
| Rate for Payer: BCBS POS |
$114.00
|
| Rate for Payer: BCBS Traditional |
$120.00
|
| Rate for Payer: CASH_PRICE |
$96.00
|
| Rate for Payer: CIGNA Commercial |
$114.00
|
| Rate for Payer: CIGNA Medicare |
$108.00
|
| Rate for Payer: HUMANA Commercial |
$108.00
|
| Rate for Payer: MEDICAID Medicaid |
$110.40
|
| Rate for Payer: MEDICARE Medicare |
$84.00
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$114.00
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$116.40
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$114.00
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$114.00
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$102.00
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$96.00
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$96.00
|
|
|
LAB BLOOD DRAW FROM IMPLANTED DEVICE
|
Facility
OP
|
$120.00
|
|
|
Service Code
|
CPT 36591
|
| Hospital Charge Code |
20211001
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$84.00 |
| Max. Negotiated Rate |
$120.00 |
| Rate for Payer: AETNA Commercial |
$114.00
|
| Rate for Payer: AETNA Medicare |
$108.00
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$114.00
|
| Rate for Payer: BCBS Healthlink |
$108.00
|
| Rate for Payer: BCBS HMK CHIP |
$108.00
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$108.00
|
| Rate for Payer: BCBS POS |
$114.00
|
| Rate for Payer: BCBS Traditional |
$120.00
|
| Rate for Payer: CASH_PRICE |
$96.00
|
| Rate for Payer: CIGNA Commercial |
$114.00
|
| Rate for Payer: CIGNA Medicare |
$108.00
|
| Rate for Payer: HUMANA Commercial |
$108.00
|
| Rate for Payer: MEDICAID Medicaid |
$110.40
|
| Rate for Payer: MEDICARE Medicare |
$84.00
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$114.00
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$116.40
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$114.00
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$114.00
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$102.00
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$96.00
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$96.00
|
|
|
LAB BLOOD TYPE ANTIGEN TESTING USING RE
|
Facility
IP
|
$86.00
|
|
|
Service Code
|
CPT 86902
|
| Hospital Charge Code |
20211001
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$60.20 |
| Max. Negotiated Rate |
$86.00 |
| Rate for Payer: AETNA Commercial |
$81.70
|
| Rate for Payer: AETNA Medicare |
$77.40
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$81.70
|
| Rate for Payer: BCBS Healthlink |
$77.40
|
| Rate for Payer: BCBS HMK CHIP |
$77.40
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$77.40
|
| Rate for Payer: BCBS POS |
$81.70
|
| Rate for Payer: BCBS Traditional |
$86.00
|
| Rate for Payer: CASH_PRICE |
$68.80
|
| Rate for Payer: CIGNA Commercial |
$81.70
|
| Rate for Payer: CIGNA Medicare |
$77.40
|
| Rate for Payer: HUMANA Commercial |
$77.40
|
| Rate for Payer: MEDICAID Medicaid |
$79.12
|
| Rate for Payer: MEDICARE Medicare |
$60.20
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$81.70
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$83.42
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$81.70
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$81.70
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$73.10
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$68.80
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$68.80
|
|
|
LAB BLOOD TYPE ANTIGEN TESTING USING RE
|
Facility
OP
|
$86.00
|
|
|
Service Code
|
CPT 86902
|
| Hospital Charge Code |
20211001
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$60.20 |
| Max. Negotiated Rate |
$86.00 |
| Rate for Payer: AETNA Commercial |
$81.70
|
| Rate for Payer: AETNA Medicare |
$77.40
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$81.70
|
| Rate for Payer: BCBS Healthlink |
$77.40
|
| Rate for Payer: BCBS HMK CHIP |
$77.40
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$77.40
|
| Rate for Payer: BCBS POS |
$81.70
|
| Rate for Payer: BCBS Traditional |
$86.00
|
| Rate for Payer: CASH_PRICE |
$68.80
|
| Rate for Payer: CIGNA Commercial |
$81.70
|
| Rate for Payer: CIGNA Medicare |
$77.40
|
| Rate for Payer: HUMANA Commercial |
$77.40
|
| Rate for Payer: MEDICAID Medicaid |
$79.12
|
| Rate for Payer: MEDICARE Medicare |
$60.20
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$81.70
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$83.42
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$81.70
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$81.70
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$73.10
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$68.80
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$68.80
|
|
|
LAB BLOOD X-MATCH
|
Facility
OP
|
$178.00
|
|
|
Service Code
|
CPT 86922
|
| Hospital Charge Code |
20211001
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$124.60 |
| Max. Negotiated Rate |
$178.00 |
| Rate for Payer: AETNA Commercial |
$169.10
|
| Rate for Payer: AETNA Medicare |
$160.20
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$169.10
|
| Rate for Payer: BCBS Healthlink |
$160.20
|
| Rate for Payer: BCBS HMK CHIP |
$160.20
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$160.20
|
| Rate for Payer: BCBS POS |
$169.10
|
| Rate for Payer: BCBS Traditional |
$178.00
|
| Rate for Payer: CASH_PRICE |
$142.40
|
| Rate for Payer: CIGNA Commercial |
$169.10
|
| Rate for Payer: CIGNA Medicare |
$160.20
|
| Rate for Payer: HUMANA Commercial |
$160.20
|
| Rate for Payer: MEDICAID Medicaid |
$163.76
|
| Rate for Payer: MEDICARE Medicare |
$124.60
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$169.10
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$172.66
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$169.10
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$169.10
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$151.30
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$142.40
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$142.40
|
|
|
LAB BLOOD X-MATCH
|
Facility
OP
|
$158.00
|
|
|
Service Code
|
CPT 86920
|
| Hospital Charge Code |
20211001
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$110.60 |
| Max. Negotiated Rate |
$158.00 |
| Rate for Payer: AETNA Commercial |
$150.10
|
| Rate for Payer: AETNA Medicare |
$142.20
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$150.10
|
| Rate for Payer: BCBS Healthlink |
$142.20
|
| Rate for Payer: BCBS HMK CHIP |
$142.20
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$142.20
|
| Rate for Payer: BCBS POS |
$150.10
|
| Rate for Payer: BCBS Traditional |
$158.00
|
| Rate for Payer: CASH_PRICE |
$126.40
|
| Rate for Payer: CIGNA Commercial |
$150.10
|
| Rate for Payer: CIGNA Medicare |
$142.20
|
| Rate for Payer: HUMANA Commercial |
$142.20
|
| Rate for Payer: MEDICAID Medicaid |
$145.36
|
| Rate for Payer: MEDICARE Medicare |
$110.60
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$150.10
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$153.26
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$150.10
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$150.10
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$134.30
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$126.40
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$126.40
|
|
|
LAB BLOOD X-MATCH
|
Facility
OP
|
$97.00
|
|
|
Service Code
|
CPT 86921
|
| Hospital Charge Code |
20211001
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$67.90 |
| Max. Negotiated Rate |
$97.00 |
| Rate for Payer: AETNA Commercial |
$92.15
|
| Rate for Payer: AETNA Medicare |
$87.30
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$92.15
|
| Rate for Payer: BCBS Healthlink |
$87.30
|
| Rate for Payer: BCBS HMK CHIP |
$87.30
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$87.30
|
| Rate for Payer: BCBS POS |
$92.15
|
| Rate for Payer: BCBS Traditional |
$97.00
|
| Rate for Payer: CASH_PRICE |
$77.60
|
| Rate for Payer: CIGNA Commercial |
$92.15
|
| Rate for Payer: CIGNA Medicare |
$87.30
|
| Rate for Payer: HUMANA Commercial |
$87.30
|
| Rate for Payer: MEDICAID Medicaid |
$89.24
|
| Rate for Payer: MEDICARE Medicare |
$67.90
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$92.15
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$94.09
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$92.15
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$92.15
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$82.45
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$77.60
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$77.60
|
|
|
LAB BLOOD X-MATCH
|
Facility
IP
|
$178.00
|
|
|
Service Code
|
CPT 86922
|
| Hospital Charge Code |
20211001
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$124.60 |
| Max. Negotiated Rate |
$178.00 |
| Rate for Payer: BCBS HMK CHIP |
$160.20
|
| Rate for Payer: AETNA Commercial |
$169.10
|
| Rate for Payer: AETNA Medicare |
$160.20
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$169.10
|
| Rate for Payer: BCBS Healthlink |
$160.20
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$160.20
|
| Rate for Payer: BCBS POS |
$169.10
|
| Rate for Payer: BCBS Traditional |
$178.00
|
| Rate for Payer: CASH_PRICE |
$142.40
|
| Rate for Payer: CIGNA Commercial |
$169.10
|
| Rate for Payer: CIGNA Medicare |
$160.20
|
| Rate for Payer: HUMANA Commercial |
$160.20
|
| Rate for Payer: MEDICAID Medicaid |
$163.76
|
| Rate for Payer: MEDICARE Medicare |
$124.60
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$169.10
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$172.66
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$169.10
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$169.10
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$151.30
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$142.40
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$142.40
|
|
|
LAB BLOOD X-MATCH
|
Facility
IP
|
$97.00
|
|
|
Service Code
|
CPT 86921
|
| Hospital Charge Code |
20211001
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$67.90 |
| Max. Negotiated Rate |
$97.00 |
| Rate for Payer: AETNA Commercial |
$92.15
|
| Rate for Payer: AETNA Medicare |
$87.30
|
| Rate for Payer: BCBS CLOSED PLAN NETWORK |
$92.15
|
| Rate for Payer: BCBS Healthlink |
$87.30
|
| Rate for Payer: BCBS HMK CHIP |
$87.30
|
| Rate for Payer: BCBS MCR ADVANTAGE Medicare Part A |
$87.30
|
| Rate for Payer: BCBS POS |
$92.15
|
| Rate for Payer: BCBS Traditional |
$97.00
|
| Rate for Payer: CASH_PRICE |
$77.60
|
| Rate for Payer: CIGNA Commercial |
$92.15
|
| Rate for Payer: CIGNA Medicare |
$87.30
|
| Rate for Payer: HUMANA Commercial |
$87.30
|
| Rate for Payer: MEDICAID Medicaid |
$89.24
|
| Rate for Payer: MEDICARE Medicare |
$67.90
|
| Rate for Payer: MONIDA - ALLEGIANCE Commercial |
$92.15
|
| Rate for Payer: MONIDA - FIRST CHOICE HEALTH Commercial |
$94.09
|
| Rate for Payer: MONIDA - MONTANA HEALTH COOP Commercial |
$92.15
|
| Rate for Payer: MONIDA - PACIFICSOURCE Commercial |
$92.15
|
| Rate for Payer: UNITED HEALTHCARE Commercial |
$82.45
|
| Rate for Payer: UNITED HEALTHCARE MCD ADVANTAGE Medicaid |
$77.60
|
| Rate for Payer: UNITED HEALTHCARE MCR ADVANTAGE RHC Medicare |
$77.60
|
|
