Does Clark Fork Valley Hospital have an emergency room?

Yes. Medicare (CMS) data lists emergency services at Clark Fork Valley Hospital. In a medical emergency, call 911.

Where is Clark Fork Valley Hospital?

10 Kruger Rd, Plains, MT 59859, in Sanders County, Montana.

What is the phone number of Clark Fork Valley Hospital?

(406) 826-4800, as listed by Medicare (CMS).

What is the Medicare star rating of Clark Fork Valley Hospital?

CMS does not show an overall star rating for this hospital. This is common, for example when a hospital reports too few quality measures or is not part of the rating program.

Clark Fork Valley Hospital — Phone, Address & ER

Quick answers

Does Clark Fork Valley Hospital have an emergency room?: Yes. Medicare (CMS) data lists emergency services at Clark Fork Valley Hospital. In a medical emergency, call 911.
Where is Clark Fork Valley Hospital?: 10 Kruger Rd, Plains, MT 59859, in Sanders County, Montana.
What is the phone number of Clark Fork Valley Hospital?: (406) 826-4800, as listed by Medicare (CMS).
What is the Medicare star rating of Clark Fork Valley Hospital?: CMS does not show an overall star rating for this hospital. This is common, for example when a hospital reports too few quality measures or is not part of the rating program.

Specialties and care areas^{[7][8][9][11][12][13][14]}

Conditions treated^[13]

Arthritis
Bursitis
Fractures
Tendonitis
Sprains and strains
Repetitive stress injuries

Treatments^[8][10]

Wound care and dressing changes
Diabetic management
Smoking cessation education

Procedures^{[10][11][13][14]}

3D mammography
CT scanning
MRI scanning
Ultrasound
DXA bone density scanning
Echocardiogram
Stress echocardiogram
Transesophageal echocardiogram
Pulmonary function test
EKG
Holter monitoring
ACL reconstruction
Shoulder and knee arthroscopy
Hip and knee joint replacement
Carpal tunnel surgery
Endoscopy
Colonoscopy
Gallbladder surgery
Hysterectomy
Breast biopsy
Lumpectomy/mastectomy
Tonsil and adenoid surgery
Thyroid/parathyroid surgery

Programs and centers^[6][8]

Visiting Nurse Program
DAISY Award

Emergency care (hospital website)^[7]

Emergency room	Yes
Open 24/7	Yes

Doctors and clinicians (122)

122 doctors and other clinicians list Clark Fork Valley Hospital as a hospital where they work, in Medicare's official clinician data (updated 2026-10-02). It is not a complete staff list.

Main specialties

And 98 more: the button below opens the full list.

Other emergency rooms nearby

Hospitals that list emergency services, by straight-line distance (not driving distance).

Mineral Community Hospital20 mi · Superior, MT · Critical Access Hospital
St Luke Community Hospital37 mi · Ronan, MT · Critical Access Hospital
Providence St Joseph Medical Center37 mi · Polson, MT · Critical Access Hospital
Logan Health Medical Center58 mi · Kalispell, MT · Acute Care Hospital
Shoshone Medical Center58 mi · Kellogg, ID · Critical Access Hospital

Find the closest emergency room to where you are → · Compare ER wait times

Other hospitals near Plains

Community Medical Center58 mi · Missoula, MT · Acute Care Hospital

Hospitals in Sanders County · Hospitals near me

Nursing homes, hospice, home health and dialysis nearby

Medicare-certified providers within 25 miles, by straight-line distance. Hospice and home health care is given at home: their address is the office.

Nursing homes

Clark Fork Valley Nursing Home0.0 mi · Plains, MT · 3 of 5 stars
Hot Springs Health & Rehabilitation Center14 mi · Hot Springs, MT · 4 of 5 stars

All nursing homes in the state →

Hospice providers

Clark Fork Valley Hospital Hospice5.6 mi · Plains, MT

All hospice providers in the state →

Community care nearby

Health centers, clinics, urgent care and pharmacies closest to this hospital, by straight-line distance, from official HRSA, Medicare and NPI Registry data. In a medical emergency, call 911.

Clinics and urgent care

Clark Fork Valley Hospital5.6 mi · Plains, MT · Rural health clinic
Hot Springs Clinic22 mi · Hot Springs, MT · Rural health clinic
Main Street Medical22 mi · Thompson Falls, MT · Rural health clinic

Pharmacies

Plains Drug Inc5.6 mi · Plains, MT · Community/retail pharmacy

About the Medicare star rating

CMS (the federal Medicare agency) gives many hospitals an overall rating from 1 to 5 stars, based on measures of mortality, safety, readmissions, patient experience and timely care. It is one piece of information: ask your doctor what matters for your care. See the full Medicare profile →

Medicare quality data

What Clark Fork Valley Hospital reported to Medicare (CMS), the federal agency that publishes these results for hospitals nationwide. These are averages for many patients, not a prediction for any one person: ask your doctor what matters for your care. In a medical emergency, call 911.

What patients said (patient survey)

What this means: Patients who stayed overnight answered a national survey (HCAHPS) about their stay. More stars mean patients reported a better experience than at other hospitals. The percentages show how often patients gave the best answer, next to the national average.

Rated the hospital 9 or 10 out of 10	80%National average: 72%
Would definitely recommend the hospital	79%National average: 71%
Nurses “always” communicated well	87%National average: 80%
Doctors “always” communicated well	79%National average: 80%
“Always” got help as soon as they wanted	79%National average: 64%
Staff “always” explained medicines before giving them	74%National average: 62%
Were given information about recovery at home	84%National average: 86%
Room and bathroom “always” clean	88%National average: 73%
Not reported to Medicare	Summary star rating (all survey topics); Overall rating of the hospital; Would recommend the hospital; Nurses communicated well; Doctors communicated well; Patients got help quickly from staff; Staff explained medicines; Information about recovery at home; Room and bathroom kept clean; Restfulness of Environment; Care Coordination; Symptoms After Stay
Completed surveys	58Response rate: 26%

Source: Patient survey (HCAHPS) - Hospital — CMS, released October 19, 2026; patients discharged January 2025 to December 2025.

Complications and deaths

What this means: Death rates are the share of patients who died within 30 days of going into the hospital for that condition, adjusted for how sick they were. PSI-90 combines several serious complications (a lower number is better). “No different from the national rate” is the most common result and means the hospital is in line with hospitals nationwide.

Deaths within 30 days: pneumonia patients	17.1%
Not reported to Medicare	Deaths within 30 days: heart attack patients; Deaths within 30 days: coronary bypass surgery (CABG); Serious complications (patient safety indicator PSI-90)
Too few cases to report	Deaths within 30 days: heart failure patients; Deaths within 30 days: COPD patients; Deaths within 30 days: stroke patients; Complications after hip or knee replacement

Source: Complications and Deaths - Hospital — CMS, released October 20, 2026; data from July 2022 to June 2025.

Return visits to the hospital (readmissions)

What this means: The share of patients who had to be admitted to a hospital again within 30 days after going home, adjusted for how sick they were. A lower percentage is better.

Returned to any hospital within 30 days (all patients)	16.3%
Readmitted within 30 days: pneumonia	16.5%
Not reported to Medicare	Readmitted within 30 days: heart attack; Readmitted within 30 days: coronary bypass surgery
Too few cases to report	Readmitted within 30 days: heart failure; Readmitted within 30 days: COPD; Readmitted within 30 days: hip or knee replacement

Source: Unplanned Hospital Visits - Hospital — CMS, released October 20, 2026; data from July 2024 to June 2025.

Emergency room times and sepsis care

What this means: ER time is the middle (median) time from arriving at the emergency room to leaving it; busier ERs usually have longer times, so the ER volume is shown too. Leaving before being seen: a lower percentage is better. Sepsis is a life-threatening reaction to an infection; a higher percentage means more patients got every recommended early step.

Emergency room volume (patients per year)	Low (under 20,000)
Average (median) time patients spent in the emergency room before leaving (OP-18b)	157 minutesNational average: 162 minutes
Patients who left the emergency room before being seen (OP-22)	1%National average: 2%
Not reported to Medicare	Sepsis patients who got all the recommended early care (SEP-1)

Source: Timely and Effective Care - Hospital — CMS, released October 19, 2026; data from January 2024 to December 2024.

Not reported to Medicare: infections caught in the hospital. For these topics Medicare shows no result for this hospital (not reported, or too few cases).

See every measure on Medicare Care Compare →

ER wait times and Medicare ratings nearby

How this hospital compares with others in the area, ranked only by official Medicare (CMS) numbers.

ER wait times in Montana

Prices

Every US hospital must publish its standard charges in a file that follows a federal (CMS) format. Below are 85 common services exactly as Clark Fork Valley Hospital lists them in its file. This is not a quote: what you pay depends on your insurance and plan, the doctors involved and the care you actually receive. Prices change: ask the hospital for an estimate before you schedule care (if you are uninsured or paying yourself, you have the right to a written “good faith estimate”). In a medical emergency, call 911.

What the prices mean

Hospital charge: The hospital’s list price (“gross charge”) before any discount or insurance. Few people pay this amount.
Cash price: The price the hospital offers if you pay yourself, without insurance (“discounted cash price”).
Insurance rates: The lowest and highest amounts the hospital has agreed with any insurance plan for the service (“de-identified minimum and maximum”), and some of the rates it lists by insurer and plan. Your share depends on your deductible, copay and coinsurance.
Hospital and doctor fees: A service can have a hospital (facility) fee and a separate doctor (professional) fee; the total for your care can include both, plus other services.

How to use hospital prices: estimates, financial assistance and your rights →

Show the prices of 85 common services

Office and emergency visits

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
New patient office visit (about 30–44 minutes) CPT 99203 · Inpatient or outpatient · Hospital (facility) fee In the file: HC PR 99203 NEW PT VISIT - LEVEL 3	$271.18	$271.18	$84.44 – $271.18
New patient office visit (about 30–44 minutes): rates for 5 insurance plans Allegiance — All: $230.50 Blue Cross Blue Shield of Montana — All: $271.18 First Choice Health — All: $271.18 Montana Health CoOp — All: $271.18 Pacific Source — All: $84.44
New patient office visit (about 45–59 minutes) CPT 99204 · Inpatient or outpatient · Hospital (facility) fee In the file: HC NEW PT VISIT - LEVEL 4	$392.39	$392.39	$136.69 – $392.39
New patient office visit (about 45–59 minutes): rates for 5 insurance plans Allegiance — All: $333.53 Blue Cross Blue Shield of Montana — All: $392.39 First Choice Health — All: $392.39 Montana Health CoOp — All: $392.39 Pacific Source — All: $136.69
New patient office visit (about 45–59 minutes) CPT 99204 · Inpatient or outpatient · Hospital (facility) fee In the file: HC PR 99204 NEW PT VISIT - LEVEL 4	$392.39	$392.39	$136.69 – $392.39
New patient office visit (about 45–59 minutes): rates for 5 insurance plans Allegiance — All: $333.53 Blue Cross Blue Shield of Montana — All: $392.39 First Choice Health — All: $392.39 Montana Health CoOp — All: $392.39 Pacific Source — All: $136.69
New patient office visit (about 45–59 minutes) CPT 99204 · Inpatient or outpatient · Hospital (facility) fee In the file: HC PR 99204 OFFICE OUTPATIENT NEW RHC	$392.39	$392.39	$136.69 – $392.39
New patient office visit (about 45–59 minutes): rates for 5 insurance plans Allegiance — All: $333.53 Blue Cross Blue Shield of Montana — All: $392.39 First Choice Health — All: $392.39 Montana Health CoOp — All: $392.39 Pacific Source — All: $136.69
New patient office visit (about 60–74 minutes) CPT 99205 · Inpatient or outpatient · Hospital (facility) fee In the file: HC PR 99205 NEW PT VISIT - LEVEL 5	$488.75	$488.75	$185.49 – $488.74
New patient office visit (about 60–74 minutes): rates for 5 insurance plans Allegiance — All: $415.43 Blue Cross Blue Shield of Montana — All: $488.74 First Choice Health — All: $488.74 Montana Health CoOp — All: $488.74 Pacific Source — All: $185.49
Established patient office visit (about 20–29 minutes) CPT 99213 · Inpatient or outpatient · Hospital (facility) fee In the file: HC L&D TRIAGE ESTAB PATIENT LVL 3 CDM	$426.35	$426.35	$67.48 – $426.34
Established patient office visit (about 20–29 minutes): rates for 5 insurance plans Allegiance — All: $362.39 Blue Cross Blue Shield of Montana — All: $426.34 First Choice Health — All: $426.34 Montana Health CoOp — All: $426.34 Pacific Source — All: $67.48
Established patient office visit (about 20–29 minutes) CPT 99213 · Inpatient or outpatient · Hospital (facility) fee In the file: HC PR 99213 ESTAB PT VISIT - LEVEL 3	$159.17	$159.17	$67.48 – $159.17
Established patient office visit (about 20–29 minutes): rates for 5 insurance plans Allegiance — All: $135.29 Blue Cross Blue Shield of Montana — All: $159.17 First Choice Health — All: $159.17 Montana Health CoOp — All: $159.17 Pacific Source — All: $67.48
Established patient office visit (about 30–39 minutes) CPT 99214 · Inpatient or outpatient · Hospital (facility) fee In the file: HC L&D TRIAGE ESTAB PATIENT LVL 4 CDM	$526.76	$526.76	$98.97 – $526.76
Established patient office visit (about 30–39 minutes): rates for 5 insurance plans Allegiance — All: $447.74 Blue Cross Blue Shield of Montana — All: $526.76 First Choice Health — All: $526.76 Montana Health CoOp — All: $526.76 Pacific Source — All: $98.97
Established patient office visit (about 30–39 minutes) CPT 99214 · Inpatient or outpatient · Hospital (facility) fee In the file: HC PR 99214 ESTAB PT VISIT - LEVEL 4	$246.32	$246.32	$98.97 – $246.32
Established patient office visit (about 30–39 minutes): rates for 5 insurance plans Allegiance — All: $209.37 Blue Cross Blue Shield of Montana — All: $246.32 First Choice Health — All: $246.32 Montana Health CoOp — All: $246.32 Pacific Source — All: $98.97
Established patient office visit (about 30–39 minutes) CPT 99214 · Inpatient or outpatient · Hospital (facility) fee In the file: HC PR 99214 OFFICE OUTPATIENT VISIT RHC	$246.32	$246.32	$98.97 – $246.32
Established patient office visit (about 30–39 minutes): rates for 5 insurance plans Allegiance — All: $209.37 Blue Cross Blue Shield of Montana — All: $246.32 First Choice Health — All: $246.32 Montana Health CoOp — All: $246.32 Pacific Source — All: $98.97
Office consultation with a specialist (moderate) CPT 99243 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OFF/OP CNSLTJ NEW/EST LOW 30	Not listed in the file	Not listed in the file	$95.51
Office consultation with a specialist (moderate): rates for 5 insurance plans Pacific Source — All: $95.51 Allegiance — All: 85% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield of Montana — All: 100% (a percentage in the contract, not a dollar amount) First Choice Health — All: 100% (a percentage in the contract, not a dollar amount) Montana Health CoOp — All: 100% (a percentage in the contract, not a dollar amount)
Office consultation with a specialist (moderate to high) CPT 99244 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OFF/OP CNSLTJ NEW/EST MOD 40	Not listed in the file	Not listed in the file	$152.61
Office consultation with a specialist (moderate to high): rates for 5 insurance plans Pacific Source — All: $152.61 Allegiance — All: 85% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield of Montana — All: 100% (a percentage in the contract, not a dollar amount) First Choice Health — All: 100% (a percentage in the contract, not a dollar amount) Montana Health CoOp — All: 100% (a percentage in the contract, not a dollar amount)
Preventive checkup, new patient, age 18–39 CPT 99385 · Inpatient or outpatient · Hospital (facility) fee In the file: HC PR 99385 DOT PHYSICAL AGE 18-39 NEW PT	$64.90	$64.90	$55.16 – $97.94
Preventive checkup, new patient, age 18–39: rates for 5 insurance plans Allegiance — All: $55.16 Blue Cross Blue Shield of Montana — All: $64.89 First Choice Health — All: $64.89 Montana Health CoOp — All: $64.89 Pacific Source — All: $97.94
Preventive checkup, new patient, age 18–39 CPT 99385 · Inpatient or outpatient · Hospital (facility) fee In the file: HC PR 99385 INITIAL PREVENTIVE MEDICINE NEW PT AGE 18-39YRS RHC	$237.90	$237.90	$97.94 – $237.90
Preventive checkup, new patient, age 18–39: rates for 5 insurance plans Allegiance — All: $202.21 Blue Cross Blue Shield of Montana — All: $237.90 First Choice Health — All: $237.90 Montana Health CoOp — All: $237.90 Pacific Source — All: $97.94
Preventive checkup, new patient, age 18–39 CPT 99385 · Inpatient or outpatient · Hospital (facility) fee In the file: HC PR 99385 PREV VISIT NEW AGE 18-39	$237.90	$237.90	$97.94 – $237.90
Preventive checkup, new patient, age 18–39: rates for 5 insurance plans Allegiance — All: $202.21 Blue Cross Blue Shield of Montana — All: $237.90 First Choice Health — All: $237.90 Montana Health CoOp — All: $237.90 Pacific Source — All: $97.94
Preventive checkup, new patient, age 40–64 CPT 99386 · Inpatient or outpatient · Hospital (facility) fee In the file: HC PR 99386 DOT PHYSICAL AGE 40-64 NEW PT	$136.66	$136.66	$116.15 – $136.65
Preventive checkup, new patient, age 40–64: rates for 5 insurance plans Allegiance — All: $116.15 Blue Cross Blue Shield of Montana — All: $136.65 First Choice Health — All: $136.65 Montana Health CoOp — All: $136.65 Pacific Source — All: $118.70
Preventive checkup, new patient, age 40–64 CPT 99386 · Inpatient or outpatient · Hospital (facility) fee In the file: HC PR 99386 PREV VISIT NEW AGE 40-64	$237.90	$237.90	$118.70 – $237.90
Preventive checkup, new patient, age 40–64: rates for 5 insurance plans Allegiance — All: $202.21 Blue Cross Blue Shield of Montana — All: $237.90 First Choice Health — All: $237.90 Montana Health CoOp — All: $237.90 Pacific Source — All: $118.70
Preventive checkup, new patient, age 40–64 CPT 99386 · Inpatient or outpatient · Hospital (facility) fee In the file: HC PR 99386 PREVENTIVE VISIT NEW 40-64 RHC	$237.90	$237.90	$118.70 – $237.90
Preventive checkup, new patient, age 40–64: rates for 5 insurance plans Allegiance — All: $202.21 Blue Cross Blue Shield of Montana — All: $237.90 First Choice Health — All: $237.90 Montana Health CoOp — All: $237.90 Pacific Source — All: $118.70
Emergency room visit (moderate) CPT 99283 · Inpatient or outpatient · Hospital (facility) fee In the file: HC ED FAC E&M VISIT LEVEL 3 CDM	$330.93	$330.93	$73.02 – $330.92
Emergency room visit (moderate): rates for 5 insurance plans Allegiance — All: $281.28 Blue Cross Blue Shield of Montana — All: $330.92 First Choice Health — All: $330.92 Montana Health CoOp — All: $330.92 Pacific Source — All: $73.02
Emergency room visit (moderate) CPT 99283 · Inpatient or outpatient · Hospital (facility) fee In the file: HC PR ED 99283 VISIT LOW MDM CDM	$252.10	$252.10	$73.02 – $252.09
Emergency room visit (moderate): rates for 5 insurance plans Allegiance — All: $214.28 Blue Cross Blue Shield of Montana — All: $252.09 First Choice Health — All: $252.09 Montana Health CoOp — All: $252.09 Pacific Source — All: $73.02
Emergency room visit (moderately high) CPT 99284 · Inpatient or outpatient · Hospital (facility) fee In the file: HC ED FAC E&M VISIT LEVEL 4 CDM	$624.31	$624.31	$123.20 – $624.31
Emergency room visit (moderately high): rates for 5 insurance plans Allegiance — All: $530.66 Blue Cross Blue Shield of Montana — All: $624.31 First Choice Health — All: $624.31 Montana Health CoOp — All: $624.31 Pacific Source — All: $123.20
Emergency room visit (moderately high) CPT 99284 · Inpatient or outpatient · Hospital (facility) fee In the file: HC PR ED 99284 VISIT MODERATE MDM CDM	$363.58	$363.58	$123.20 – $363.58
Emergency room visit (moderately high): rates for 5 insurance plans Allegiance — All: $309.04 Blue Cross Blue Shield of Montana — All: $363.58 First Choice Health — All: $363.58 Montana Health CoOp — All: $363.58 Pacific Source — All: $123.20
Emergency room visit (high) CPT 99285 · Inpatient or outpatient · Hospital (facility) fee In the file: HC ED FAC E&M VISIT LEVEL 5 CDM	$1,115.30	$1,115.30	$178.91 – $1,115.29
Emergency room visit (high): rates for 5 insurance plans Allegiance — All: $948 Blue Cross Blue Shield of Montana — All: $1,115.29 First Choice Health — All: $1,115.29 Montana Health CoOp — All: $1,115.29 Pacific Source — All: $178.91
Emergency room visit (high) CPT 99285 · Inpatient or outpatient · Hospital (facility) fee In the file: HC PR ED 99285 VISIT HIGH MDM CDM	$530.61	$530.61	$178.91 – $530.60
Emergency room visit (high): rates for 5 insurance plans Allegiance — All: $451.01 Blue Cross Blue Shield of Montana — All: $530.60 First Choice Health — All: $530.60 Montana Health CoOp — All: $530.60 Pacific Source — All: $178.91

Lab tests

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Basic metabolic panel (blood test) CPT 80048 · Inpatient or outpatient · Hospital (facility) fee In the file: BMP	$142.84	$142.84	$121.41 – $142.84
Basic metabolic panel (blood test): rates for 5 insurance plans Allegiance — All: $121.41 Blue Cross Blue Shield of Montana — All: $142.84 First Choice Health — All: $142.84 Montana Health CoOp — All: $142.84 Pacific Source — All: $121.41
Basic metabolic panel (blood test) CPT 80048 · Inpatient or outpatient · Hospital (facility) fee In the file: HC BASIC METABOLIC PANEL	$147.16	$147.16	$125.08 – $147.16
Basic metabolic panel (blood test): rates for 5 insurance plans Allegiance — All: $125.08 Blue Cross Blue Shield of Montana — All: $147.16 First Choice Health — All: $147.16 Montana Health CoOp — All: $147.16 Pacific Source — All: $125.08
Comprehensive metabolic panel (blood test) CPT 80053 · Inpatient or outpatient · Hospital (facility) fee In the file: HC COMPREHEN METABOLIC PANEL	$41.60	$41.60	$35.36 – $41.60
Comprehensive metabolic panel (blood test): rates for 5 insurance plans Allegiance — All: $35.36 Blue Cross Blue Shield of Montana — All: $41.60 First Choice Health — All: $41.60 Montana Health CoOp — All: $41.60 Pacific Source — All: $35.36
Comprehensive metabolic panel (blood test) CPT 80053 · Inpatient or outpatient · Hospital (facility) fee In the file: cmp	$227.55	$227.55	$193.41 – $227.55
Comprehensive metabolic panel (blood test): rates for 5 insurance plans Allegiance — All: $193.41 Blue Cross Blue Shield of Montana — All: $227.55 First Choice Health — All: $227.55 Montana Health CoOp — All: $227.55 Pacific Source — All: $193.41
Cholesterol panel (lipid panel) CPT 80061 · Inpatient or outpatient · Hospital (facility) fee In the file: HC LIPID PANEL	$8.94	$8.94	$7.60 – $8.94
Cholesterol panel (lipid panel): rates for 5 insurance plans Allegiance — All: $7.60 Blue Cross Blue Shield of Montana — All: $8.94 First Choice Health — All: $8.94 Montana Health CoOp — All: $8.94 Pacific Source — All: $7.60
Cholesterol panel (lipid panel) CPT 80061 · Inpatient or outpatient · Hospital (facility) fee In the file: HC LIPID PANEL #	$8.94	$8.94	$7.60 – $8.94
Cholesterol panel (lipid panel): rates for 5 insurance plans Allegiance — All: $7.60 Blue Cross Blue Shield of Montana — All: $8.94 First Choice Health — All: $8.94 Montana Health CoOp — All: $8.94 Pacific Source — All: $7.60
Cholesterol panel (lipid panel) CPT 80061 · Inpatient or outpatient · Hospital (facility) fee In the file: HC LIPID PANEL (RL)	$87.20	$87.20	$74.12 – $87.20
Cholesterol panel (lipid panel): rates for 5 insurance plans Allegiance — All: $74.12 Blue Cross Blue Shield of Montana — All: $87.20 First Choice Health — All: $87.20 Montana Health CoOp — All: $87.20 Pacific Source — All: $74.12
Kidney function panel CPT 80069 · Inpatient or outpatient · Hospital (facility) fee In the file: HC RENAL PANEL	$210.18	$210.18	$178.65 – $210.18
Kidney function panel: rates for 5 insurance plans Allegiance — All: $178.65 Blue Cross Blue Shield of Montana — All: $210.18 First Choice Health — All: $210.18 Montana Health CoOp — All: $210.18 Pacific Source — All: $178.65
Kidney function panel CPT 80069 · Inpatient or outpatient · Hospital (facility) fee In the file: RENAL FUNCTION PANEL	$188.66	$188.66	$160.35 – $188.65
Kidney function panel: rates for 5 insurance plans Allegiance — All: $160.35 Blue Cross Blue Shield of Montana — All: $188.65 First Choice Health — All: $188.65 Montana Health CoOp — All: $188.65 Pacific Source — All: $160.35
Liver function panel CPT 80076 · Inpatient or outpatient · Hospital (facility) fee In the file: HC HEPATIC FUNCTION PANEL	$165.72	$165.72	$140.86 – $165.72
Liver function panel: rates for 5 insurance plans Allegiance — All: $140.86 Blue Cross Blue Shield of Montana — All: $165.72 First Choice Health — All: $165.72 Montana Health CoOp — All: $165.72 Pacific Source — All: $140.86
Liver function panel CPT 80076 · Inpatient or outpatient · Hospital (facility) fee In the file: HEPATIC FUNCTION PANEL	$148.77	$148.77	$126.45 – $148.77
Liver function panel: rates for 5 insurance plans Allegiance — All: $126.45 Blue Cross Blue Shield of Montana — All: $148.77 First Choice Health — All: $148.77 Montana Health CoOp — All: $148.77 Pacific Source — All: $126.45
Urine test (automated, with microscope) CPT 81001 · Inpatient or outpatient · Hospital (facility) fee In the file: HC URINALYSIS AUTO W/SCOPE	$32.14	$32.14	$27.31 – $32.13
Urine test (automated, with microscope): rates for 5 insurance plans Allegiance — All: $27.31 Blue Cross Blue Shield of Montana — All: $32.13 First Choice Health — All: $32.13 Montana Health CoOp — All: $32.13 Pacific Source — All: $27.31
Urine test (automated, with microscope) CPT 81001 · Inpatient or outpatient · Hospital (facility) fee In the file: HC URNLS DIP STICK/TABLET REAGENT AUTO MICROSCOPY #	$32.14	$32.14	$27.31 – $32.13
Urine test (automated, with microscope): rates for 5 insurance plans Allegiance — All: $27.31 Blue Cross Blue Shield of Montana — All: $32.13 First Choice Health — All: $32.13 Montana Health CoOp — All: $32.13 Pacific Source — All: $27.31
Urine test (manual, without microscope) CPT 81002 · Inpatient or outpatient · Hospital (facility) fee In the file: HC DIP UA IF NOT SENT TO LAB	$24.54	$24.54	$20.86 – $24.54
Urine test (manual, without microscope): rates for 5 insurance plans Allegiance — All: $20.86 Blue Cross Blue Shield of Montana — All: $24.54 First Choice Health — All: $24.54 Montana Health CoOp — All: $24.54 Pacific Source — All: $20.86
Urine test (manual, without microscope) CPT 81002 · Inpatient or outpatient · Hospital (facility) fee In the file: HC URINALYSIS NONAUTO W/O SCOPE	$32.14	$32.14	$27.31 – $32.13
Urine test (manual, without microscope): rates for 5 insurance plans Allegiance — All: $27.31 Blue Cross Blue Shield of Montana — All: $32.13 First Choice Health — All: $32.13 Montana Health CoOp — All: $32.13 Pacific Source — All: $27.31
Urine test (automated, without microscope) CPT 81003 · Inpatient or outpatient · Hospital (facility) fee In the file: HC KETONE URINE QUALITATIVE	$87.57	$87.57	$74.43 – $87.56
Urine test (automated, without microscope): rates for 5 insurance plans Allegiance — All: $74.43 Blue Cross Blue Shield of Montana — All: $87.56 First Choice Health — All: $87.56 Montana Health CoOp — All: $87.56 Pacific Source — All: $74.43
Urine test (automated, without microscope) CPT 81003 · Inpatient or outpatient · Hospital (facility) fee In the file: HC URINALYSIS AUTO W/O SCOPE	$32.14	$32.14	$27.31 – $32.13
Urine test (automated, without microscope): rates for 5 insurance plans Allegiance — All: $27.31 Blue Cross Blue Shield of Montana — All: $32.13 First Choice Health — All: $32.13 Montana Health CoOp — All: $32.13 Pacific Source — All: $27.31
Urine test (automated, without microscope) CPT 81003 · Inpatient or outpatient · Hospital (facility) fee In the file: HC URNLS DIP STICK/TABLET RGNT AUTO W/O MICROSCOPY #	$32.14	$32.14	$27.31 – $32.13
Urine test (automated, without microscope): rates for 5 insurance plans Allegiance — All: $27.31 Blue Cross Blue Shield of Montana — All: $32.13 First Choice Health — All: $32.13 Montana Health CoOp — All: $32.13 Pacific Source — All: $27.31
PSA (prostate specific antigen) blood test CPT 84153 · Inpatient or outpatient · Hospital (facility) fee In the file: HC ASSAY OF PROSTATE SPECIFIC ANTIGEN TOTAL #	$13.52	$13.52	$11.49 – $13.52
PSA (prostate specific antigen) blood test: rates for 5 insurance plans Allegiance — All: $11.49 Blue Cross Blue Shield of Montana — All: $13.52 First Choice Health — All: $13.52 Montana Health CoOp — All: $13.52 Pacific Source — All: $11.49
PSA (prostate specific antigen) blood test CPT 84153 · Inpatient or outpatient · Hospital (facility) fee In the file: HC PROSTATE SPEC ANTIGEN(PSA)TOTAL	$117.26	$117.26	$99.67 – $117.26
PSA (prostate specific antigen) blood test: rates for 5 insurance plans Allegiance — All: $99.67 Blue Cross Blue Shield of Montana — All: $117.26 First Choice Health — All: $117.26 Montana Health CoOp — All: $117.26 Pacific Source — All: $99.67
PSA (prostate specific antigen) blood test CPT 84153 · Inpatient or outpatient · Hospital (facility) fee In the file: HC PROSTATE SPECIFIC ANTIGEN (PSA) TOTAL	$13.52	$13.52	$11.49 – $13.52
PSA (prostate specific antigen) blood test: rates for 5 insurance plans Allegiance — All: $11.49 Blue Cross Blue Shield of Montana — All: $13.52 First Choice Health — All: $13.52 Montana Health CoOp — All: $13.52 Pacific Source — All: $11.49
Thyroid stimulating hormone (TSH) test CPT 84443 · Inpatient or outpatient · Hospital (facility) fee In the file: HC ASSAY OF THYROID STIMULATING HORMONE TSH #	$13.42	$13.42	$11.40 – $13.41
Thyroid stimulating hormone (TSH) test: rates for 5 insurance plans Allegiance — All: $11.40 Blue Cross Blue Shield of Montana — All: $13.41 First Choice Health — All: $13.41 Montana Health CoOp — All: $13.41 Pacific Source — All: $11.40
Thyroid stimulating hormone (TSH) test CPT 84443 · Inpatient or outpatient · Hospital (facility) fee In the file: HC REFLEXIVE TSH	$117.26	$117.26	$99.67 – $117.26
Thyroid stimulating hormone (TSH) test: rates for 5 insurance plans Allegiance — All: $99.67 Blue Cross Blue Shield of Montana — All: $117.26 First Choice Health — All: $117.26 Montana Health CoOp — All: $117.26 Pacific Source — All: $99.67
Thyroid stimulating hormone (TSH) test CPT 84443 · Inpatient or outpatient · Hospital (facility) fee In the file: HC THYROID STIMULATING HORMONE (TSH)	$117.26	$117.26	$99.67 – $117.26
Thyroid stimulating hormone (TSH) test: rates for 5 insurance plans Allegiance — All: $99.67 Blue Cross Blue Shield of Montana — All: $117.26 First Choice Health — All: $117.26 Montana Health CoOp — All: $117.26 Pacific Source — All: $99.67
Complete blood count (CBC) with differential CPT 85025 · Inpatient or outpatient · Hospital (facility) fee In the file: CBC w	$103.17	$103.17	$87.69 – $103.16
Complete blood count (CBC) with differential: rates for 5 insurance plans Allegiance — All: $87.69 Blue Cross Blue Shield of Montana — All: $103.16 First Choice Health — All: $103.16 Montana Health CoOp — All: $103.16 Pacific Source — All: $87.69
Complete blood count (CBC) with differential CPT 85025 · Inpatient or outpatient · Hospital (facility) fee In the file: HC BLOOD COUNT COMPLETE AUTO&AUTO DIFRNTL WBC #	$20.12	$20.12	$17.10 – $20.12
Complete blood count (CBC) with differential: rates for 5 insurance plans Allegiance — All: $17.10 Blue Cross Blue Shield of Montana — All: $20.12 First Choice Health — All: $20.12 Montana Health CoOp — All: $20.12 Pacific Source — All: $17.10
Complete blood count (CBC) with differential CPT 85025 · Inpatient or outpatient · Hospital (facility) fee In the file: HC CBC WITH DIFF AUTO	$20.12	$20.12	$17.10 – $20.12
Complete blood count (CBC) with differential: rates for 5 insurance plans Allegiance — All: $17.10 Blue Cross Blue Shield of Montana — All: $20.12 First Choice Health — All: $20.12 Montana Health CoOp — All: $20.12 Pacific Source — All: $17.10
Complete blood count (CBC), automated CPT 85027 · Inpatient or outpatient · Hospital (facility) fee In the file: DRUGS OF ABUSE,SCREEN,URINE	$94.85	$94.85	$80.62 – $94.84
Complete blood count (CBC), automated: rates for 5 insurance plans Allegiance — All: $80.62 Blue Cross Blue Shield of Montana — All: $94.84 First Choice Health — All: $94.84 Montana Health CoOp — All: $94.84 Pacific Source — All: $80.62
Complete blood count (CBC), automated CPT 85027 · Inpatient or outpatient · Hospital (facility) fee In the file: HC BLOOD COUNT COMPLETE AUTOMATED	$8.37	$8.37	$7.11 – $8.37
Complete blood count (CBC), automated: rates for 5 insurance plans Allegiance — All: $7.11 Blue Cross Blue Shield of Montana — All: $8.37 First Choice Health — All: $8.37 Montana Health CoOp — All: $8.37 Pacific Source — All: $7.11
Complete blood count (CBC), automated CPT 85027 · Inpatient or outpatient · Hospital (facility) fee In the file: HC BLOOD COUNT COMPLETE AUTOMATED #	$8.37	$8.37	$7.11 – $8.37
Complete blood count (CBC), automated: rates for 5 insurance plans Allegiance — All: $7.11 Blue Cross Blue Shield of Montana — All: $8.37 First Choice Health — All: $8.37 Montana Health CoOp — All: $8.37 Pacific Source — All: $7.11
Blood clotting time test (prothrombin time, PT) CPT 85610 · Inpatient or outpatient · Hospital (facility) fee In the file: HC AC PROTIME	$44.98	$44.98	$38.23 – $44.98
Blood clotting time test (prothrombin time, PT): rates for 5 insurance plans Allegiance — All: $38.23 Blue Cross Blue Shield of Montana — All: $44.98 First Choice Health — All: $44.98 Montana Health CoOp — All: $44.98 Pacific Source — All: $38.23
Blood clotting time test (prothrombin time, PT) CPT 85610 · Inpatient or outpatient · Hospital (facility) fee In the file: HC LUPUS ANTICOAG-PT	$273.52	$273.52	$232.49 – $273.52
Blood clotting time test (prothrombin time, PT): rates for 5 insurance plans Allegiance — All: $232.49 Blue Cross Blue Shield of Montana — All: $273.52 First Choice Health — All: $273.52 Montana Health CoOp — All: $273.52 Pacific Source — All: $232.49
Blood clotting time test (prothrombin time, PT) CPT 85610 · Inpatient or outpatient · Hospital (facility) fee In the file: HC PR 85610 PROTHROMBIN TIME	$65.99	$65.99	$56.08 – $65.98
Blood clotting time test (prothrombin time, PT): rates for 5 insurance plans Allegiance — All: $56.08 Blue Cross Blue Shield of Montana — All: $65.98 First Choice Health — All: $65.98 Montana Health CoOp — All: $65.98 Pacific Source — All: $56.08
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Inpatient or outpatient · Hospital (facility) fee In the file: HC PTT (LUPUS ANTICOAG) PLASMA	$115.13	$115.13	$97.85 – $115.12
Blood clotting test (partial thromboplastin time, PTT): rates for 5 insurance plans Allegiance — All: $97.85 Blue Cross Blue Shield of Montana — All: $115.12 First Choice Health — All: $115.12 Montana Health CoOp — All: $115.12 Pacific Source — All: $97.85
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Inpatient or outpatient · Hospital (facility) fee In the file: HC THROMBOPLASTIN TIME PARTIAL	$33.44	$33.44	$28.42 – $33.43
Blood clotting test (partial thromboplastin time, PTT): rates for 5 insurance plans Allegiance — All: $28.42 Blue Cross Blue Shield of Montana — All: $33.43 First Choice Health — All: $33.43 Montana Health CoOp — All: $33.43 Pacific Source — All: $28.42
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Inpatient or outpatient · Hospital (facility) fee In the file: HC THROMBOPLASTIN TIME PARTIAL PLASMA/WHOLE BLOOD #	$33.44	$33.44	$28.42 – $33.43
Blood clotting test (partial thromboplastin time, PTT): rates for 5 insurance plans Allegiance — All: $28.42 Blue Cross Blue Shield of Montana — All: $33.43 First Choice Health — All: $33.43 Montana Health CoOp — All: $33.43 Pacific Source — All: $28.42

Imaging (X-ray, CT, MRI, ultrasound, mammogram)

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
CT scan of the head or brain, without contrast CPT 70450 · Inpatient or outpatient · Hospital (facility) fee In the file: HC CT HEAD/BRAIN WO CONTRAST	$1,177.44	$1,177.44	$113.16 – $1,177.43
CT scan of the head or brain, without contrast: rates for 5 insurance plans Allegiance — All: $1,000.82 Blue Cross Blue Shield of Montana — All: $1,177.43 First Choice Health — All: $1,177.43 Montana Health CoOp — All: $1,177.43 Pacific Source — All: $113.16
MRI of the brain, before and after contrast CPT 70553 · Inpatient or outpatient · Hospital (facility) fee In the file: HC MRI BRAIN W/O & W/DYE	$865.28	$865.28	$346.41 – $865.28
MRI of the brain, before and after contrast: rates for 5 insurance plans Allegiance — All: $735.48 Blue Cross Blue Shield of Montana — All: $865.28 First Choice Health — All: $865.28 Montana Health CoOp — All: $865.28 Pacific Source — All: $346.41
Chest X-ray, 2 views CPT 71046 · Inpatient or outpatient · Hospital (facility) fee In the file: HC XR CHEST 2 VIEWS	$185.07	$185.07	$34.61 – $185.06
Chest X-ray, 2 views: rates for 5 insurance plans Allegiance — All: $157.30 Blue Cross Blue Shield of Montana — All: $185.06 First Choice Health — All: $185.06 Montana Health CoOp — All: $185.06 Pacific Source — All: $34.61
X-ray of the lower spine, at least 4 views CPT 72110 · Inpatient or outpatient · Hospital (facility) fee In the file: HC SPINE LUMBOSACRAL MIN 4 VIEWS	$334.15	$334.15	$52.95 – $334.15
X-ray of the lower spine, at least 4 views: rates for 5 insurance plans Allegiance — All: $284.02 Blue Cross Blue Shield of Montana — All: $334.15 First Choice Health — All: $334.15 Montana Health CoOp — All: $334.15 Pacific Source — All: $52.95
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Inpatient or outpatient · Hospital (facility) fee In the file: HC MRI LUMBAR SPINE W/O DYE	$2,024.36	$2,024.36	$207.64 – $2,024.36
MRI of the lower back (lumbar spine), without contrast: rates for 5 insurance plans Allegiance — All: $1,720.70 Blue Cross Blue Shield of Montana — All: $2,024.36 First Choice Health — All: $2,024.36 Montana Health CoOp — All: $2,024.36 Pacific Source — All: $207.64
CT scan of the pelvis, with contrast CPT 72193 · Inpatient or outpatient · Hospital (facility) fee In the file: HC CT PELVIS W CONTRAST	$1,659.74	$1,659.74	$251.59 – $1,659.73
CT scan of the pelvis, with contrast: rates for 5 insurance plans Allegiance — All: $1,410.77 Blue Cross Blue Shield of Montana — All: $1,659.73 First Choice Health — All: $1,659.73 Montana Health CoOp — All: $1,659.73 Pacific Source — All: $251.59
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Inpatient or outpatient · Hospital (facility) fee In the file: HC MRI LOWER EXTREMITY JOINT WO CONTRAST	$1,822.24	$1,822.24	$219.06 – $1,822.23
MRI of a leg joint (such as the knee), without contrast: rates for 5 insurance plans Allegiance — All: $1,548.90 Blue Cross Blue Shield of Montana — All: $1,822.23 First Choice Health — All: $1,822.23 Montana Health CoOp — All: $1,822.23 Pacific Source — All: $219.06
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Inpatient or outpatient · Hospital (facility) fee In the file: HC CT ABDOMEN & PELVIS W CONTRAST	$3,428.31	$3,428.31	$333.26 – $3,428.30
CT scan of the abdomen and pelvis, with contrast: rates for 5 insurance plans Allegiance — All: $2,914.06 Blue Cross Blue Shield of Montana — All: $3,428.30 First Choice Health — All: $3,428.30 Montana Health CoOp — All: $3,428.30 Pacific Source — All: $333.26
Ultrasound of the abdomen, complete CPT 76700 · Inpatient or outpatient · Hospital (facility) fee In the file: HC US EXAM ABDOMEN COMPLETE	$600.18	$600.18	$122.16 – $600.18
Ultrasound of the abdomen, complete: rates for 5 insurance plans Allegiance — All: $510.15 Blue Cross Blue Shield of Montana — All: $600.18 First Choice Health — All: $600.18 Montana Health CoOp — All: $600.18 Pacific Source — All: $122.16
Ultrasound of the abdomen, complete CPT 76700 · Inpatient or outpatient · Hospital (facility) fee In the file: US ABD COMPLETE	$538.72	$538.72	$122.16 – $538.72
Ultrasound of the abdomen, complete: rates for 5 insurance plans Allegiance — All: $457.91 Blue Cross Blue Shield of Montana — All: $538.72 First Choice Health — All: $538.72 Montana Health CoOp — All: $538.72 Pacific Source — All: $122.16
Pregnancy ultrasound (after the first trimester) CPT 76805 · Inpatient or outpatient · Hospital (facility) fee In the file: HC US OB >= 14 WKS SINGLE FETUS	$574.03	$574.03	$140.16 – $574.02
Pregnancy ultrasound (after the first trimester): rates for 5 insurance plans Allegiance — All: $487.92 Blue Cross Blue Shield of Montana — All: $574.02 First Choice Health — All: $574.02 Montana Health CoOp — All: $574.02 Pacific Source — All: $140.16
Pregnancy ultrasound (after the first trimester) CPT 76805 · Inpatient or outpatient · Hospital (facility) fee In the file: US OB 14+ SINGLE OR FIRST	$515.22	$515.22	$140.16 – $515.21
Pregnancy ultrasound (after the first trimester): rates for 5 insurance plans Allegiance — All: $437.93 Blue Cross Blue Shield of Montana — All: $515.21 First Choice Health — All: $515.21 Montana Health CoOp — All: $515.21 Pacific Source — All: $140.16
Transvaginal ultrasound CPT 76830 · Inpatient or outpatient · Hospital (facility) fee In the file: HC US TRANSVAGINAL NON-OB	$420.26	$420.26	$124.93 – $420.26
Transvaginal ultrasound: rates for 5 insurance plans Allegiance — All: $357.22 Blue Cross Blue Shield of Montana — All: $420.26 First Choice Health — All: $420.26 Montana Health CoOp — All: $420.26 Pacific Source — All: $124.93
Diagnostic mammogram, one breast CPT 77065 · Inpatient or outpatient · Hospital (facility) fee In the file: HC MAMMO DIAG UNI W CAD	$294.58	$294.58	$130.12 – $294.58
Diagnostic mammogram, one breast: rates for 5 insurance plans Allegiance — All: $250.39 Blue Cross Blue Shield of Montana — All: $294.58 First Choice Health — All: $294.58 Montana Health CoOp — All: $294.58 Pacific Source — All: $130.12
Diagnostic mammogram, one breast CPT 77065 · Inpatient or outpatient · Hospital (facility) fee In the file: MAMMO DIAG UNILAT WI US UNILAT	$415.43	$415.43	$130.12 – $415.42
Diagnostic mammogram, one breast: rates for 5 insurance plans Allegiance — All: $353.11 Blue Cross Blue Shield of Montana — All: $415.42 First Choice Health — All: $415.42 Montana Health CoOp — All: $415.42 Pacific Source — All: $130.12
Diagnostic mammogram, both breasts CPT 77066 · Inpatient or outpatient · Hospital (facility) fee In the file: HC MAMMO DIAG BIL W CAD	$401.70	$401.70	$164.38 – $401.70
Diagnostic mammogram, both breasts: rates for 5 insurance plans Allegiance — All: $341.44 Blue Cross Blue Shield of Montana — All: $401.70 First Choice Health — All: $401.70 Montana Health CoOp — All: $401.70 Pacific Source — All: $164.38
Screening mammogram, both breasts CPT 77067 · Inpatient or outpatient · Hospital (facility) fee In the file: HC MAMMO SCREEN BIL W CAD	$294.58	$294.58	$132.54 – $294.58
Screening mammogram, both breasts: rates for 5 insurance plans Allegiance — All: $250.39 Blue Cross Blue Shield of Montana — All: $294.58 First Choice Health — All: $294.58 Montana Health CoOp — All: $294.58 Pacific Source — All: $132.54
Screening mammogram, both breasts CPT 77067 · Inpatient or outpatient · Hospital (facility) fee In the file: HC MAMMO SCREEN UNIL/BIL W CAD	$221.78	$221.78	$132.54 – $221.78
Screening mammogram, both breasts: rates for 5 insurance plans Allegiance — All: $188.51 Blue Cross Blue Shield of Montana — All: $221.78 First Choice Health — All: $221.78 Montana Health CoOp — All: $221.78 Pacific Source — All: $132.54
Screening mammogram, both breasts CPT 77067 · Inpatient or outpatient · Hospital (facility) fee In the file: MAMMO BILAT SCREEN	$236.50	$236.50	$132.54 – $236.49
Screening mammogram, both breasts: rates for 5 insurance plans Allegiance — All: $201.02 Blue Cross Blue Shield of Montana — All: $236.49 First Choice Health — All: $236.49 Montana Health CoOp — All: $236.49 Pacific Source — All: $132.54

Heart tests and sleep study

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Electrocardiogram (ECG/EKG) with reading CPT 93000 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ELECTROCARDIOGRAM COMPLETE	Not listed in the file	Not listed in the file	$14.53
Electrocardiogram (ECG/EKG) with reading: rates for 5 insurance plans Pacific Source — All: $14.53 Allegiance — All: 85% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield of Montana — All: 100% (a percentage in the contract, not a dollar amount) First Choice Health — All: 100% (a percentage in the contract, not a dollar amount) Montana Health CoOp — All: 100% (a percentage in the contract, not a dollar amount)
Left heart catheterization (diagnostic) CPT 93452 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LEFT HRT CATH W/VENTRCLGRPHY	Not listed in the file	Not listed in the file	$967.59
Left heart catheterization (diagnostic): rates for 5 insurance plans Pacific Source — All: $967.59 Allegiance — All: 85% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield of Montana — All: 100% (a percentage in the contract, not a dollar amount) First Choice Health — All: 100% (a percentage in the contract, not a dollar amount) Montana Health CoOp — All: 100% (a percentage in the contract, not a dollar amount)
Heart rhythm study (electrophysiology evaluation) CPT 93619 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ELECTROPHYSIOLOGY EVALUATION	Not listed in the file	Not listed in the file	Not listed in the file
Heart rhythm study (electrophysiology evaluation): rates for 5 insurance plans Allegiance — All: 85% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield of Montana — All: 100% (a percentage in the contract, not a dollar amount) First Choice Health — All: 100% (a percentage in the contract, not a dollar amount) Montana Health CoOp — All: 100% (a percentage in the contract, not a dollar amount) Pacific Source — All: 85% (a percentage in the contract, not a dollar amount)
Heart rhythm study with ablation for atrial fibrillation CPT 93656 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COMPRE EP EVAL ABLTJ ATR FIB	Not listed in the file	Not listed in the file	$1,137.16
Heart rhythm study with ablation for atrial fibrillation: rates for 5 insurance plans Pacific Source — All: $1,137.16 Allegiance — All: 85% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield of Montana — All: 100% (a percentage in the contract, not a dollar amount) First Choice Health — All: 100% (a percentage in the contract, not a dollar amount) Montana Health CoOp — All: 100% (a percentage in the contract, not a dollar amount)
Sleep study (overnight, in a sleep lab) CPT 95810 · Inpatient or outpatient · Hospital (facility) fee In the file: HC POLYSOMNOGRAPHY 4 OR MORE	$2,496.26	$2,496.26	$621.87 – $2,496.26
Sleep study (overnight, in a sleep lab): rates for 5 insurance plans Allegiance — All: $2,121.82 Blue Cross Blue Shield of Montana — All: $2,496.26 First Choice Health — All: $2,496.26 Montana Health CoOp — All: $2,496.26 Pacific Source — All: $621.87
Sleep study (overnight, in a sleep lab) CPT 95810 · Inpatient or outpatient · Hospital (facility) fee In the file: HC PR 95810 POLYSOMNOGRAPHY 4 OR MORE	$877.71	$877.71	$621.87 – $877.70
Sleep study (overnight, in a sleep lab): rates for 5 insurance plans Allegiance — All: $746.05 Blue Cross Blue Shield of Montana — All: $877.70 First Choice Health — All: $877.70 Montana Health CoOp — All: $877.70 Pacific Source — All: $621.87
Sleep study (overnight, in a sleep lab) CPT 95810 · Inpatient or outpatient · Hospital (facility) fee In the file: sleep diag	$3,028.43	$3,028.43	$621.87 – $3,028.42
Sleep study (overnight, in a sleep lab): rates for 5 insurance plans Allegiance — All: $2,574.16 Blue Cross Blue Shield of Montana — All: $3,028.42 First Choice Health — All: $3,028.42 Montana Health CoOp — All: $3,028.42 Pacific Source — All: $621.87

Physical therapy and mental health

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Inpatient or outpatient · Hospital (facility) fee In the file: HB TERM HC CONTRACT OT PER HOUR	$75.71	$75.71	$30.11 – $75.71
Physical therapy: therapeutic exercise (each 15 minutes): rates for 5 insurance plans Allegiance — All: $64.35 Blue Cross Blue Shield of Montana — All: $75.71 First Choice Health — All: $75.71 Montana Health CoOp — All: $75.71 Pacific Source — All: $30.11
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Inpatient or outpatient · Hospital (facility) fee In the file: HC CONTRACT OT PER 30 MIN- THER EXER CCMCF	$43.26	$43.26	$30.11 – $43.26
Physical therapy: therapeutic exercise (each 15 minutes): rates for 5 insurance plans Allegiance — All: $36.77 Blue Cross Blue Shield of Montana — All: $43.26 First Choice Health — All: $43.26 Montana Health CoOp — All: $43.26 Pacific Source — All: $30.11
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Inpatient or outpatient · Hospital (facility) fee In the file: HC THER EXERCISES PX 1/> AREAS EACH 15 MIN	$101.35	$101.35	$30.11 – $101.34
Physical therapy: therapeutic exercise (each 15 minutes): rates for 5 insurance plans Allegiance — All: $86.14 Blue Cross Blue Shield of Montana — All: $101.34 First Choice Health — All: $101.34 Montana Health CoOp — All: $101.34 Pacific Source — All: $30.11
Physical therapy evaluation (low complexity) CPT 97161 · Inpatient or outpatient · Hospital (facility) fee In the file: HC PT EVALUATION LOW COMPLEX	$239.93	$239.93	$102.43 – $239.92
Physical therapy evaluation (low complexity): rates for 5 insurance plans Allegiance — All: $203.93 Blue Cross Blue Shield of Montana — All: $239.92 First Choice Health — All: $239.92 Montana Health CoOp — All: $239.92 Pacific Source — All: $102.43
Physical therapy evaluation (moderate complexity) CPT 97162 · Inpatient or outpatient · Hospital (facility) fee In the file: HC PT EVALUATION MOD COMPLEX	$299.83	$299.83	$102.43 – $299.83
Physical therapy evaluation (moderate complexity): rates for 5 insurance plans Allegiance — All: $254.85 Blue Cross Blue Shield of Montana — All: $299.83 First Choice Health — All: $299.83 Montana Health CoOp — All: $299.83 Pacific Source — All: $102.43
Physical therapy evaluation (high complexity) CPT 97163 · Inpatient or outpatient · Hospital (facility) fee In the file: HC PT EVALUATION HIGH COMPLEX	$344.81	$344.81	$102.43 – $344.81
Physical therapy evaluation (high complexity): rates for 5 insurance plans Allegiance — All: $293.09 Blue Cross Blue Shield of Montana — All: $344.81 First Choice Health — All: $344.81 Montana Health CoOp — All: $344.81 Pacific Source — All: $102.43
Psychotherapy, 30 minutes CPT 90832 · Inpatient or outpatient · Hospital (facility) fee In the file: HC PR 90832 PSYCHOTHERAPY W/PATIENT 30 MINUTES	$81.12	$81.12	$68.87 – $81.12
Psychotherapy, 30 minutes: rates for 5 insurance plans Allegiance — All: $68.95 Blue Cross Blue Shield of Montana — All: $81.12 First Choice Health — All: $81.12 Montana Health CoOp — All: $81.12 Pacific Source — All: $68.87
Psychotherapy, 30 minutes CPT 90832 · Inpatient or outpatient · Hospital (facility) fee In the file: HC PR 90832 PSYTX W PT 30 MIN RHC	$144.72	$144.72	$68.87 – $144.71
Psychotherapy, 30 minutes: rates for 5 insurance plans Allegiance — All: $123 Blue Cross Blue Shield of Montana — All: $144.71 First Choice Health — All: $144.71 Montana Health CoOp — All: $144.71 Pacific Source — All: $68.87
Psychotherapy, 45 minutes CPT 90834 · Inpatient or outpatient · Hospital (facility) fee In the file: HC PR 90834 PSYCHOTHERAPY W/PATIENT 45 MINUTES	$81.12	$81.12	$68.95 – $90.67
Psychotherapy, 45 minutes: rates for 5 insurance plans Allegiance — All: $68.95 Blue Cross Blue Shield of Montana — All: $81.12 First Choice Health — All: $81.12 Montana Health CoOp — All: $81.12 Pacific Source — All: $90.67
Psychotherapy, 45 minutes CPT 90834 · Inpatient or outpatient · Hospital (facility) fee In the file: HC PR 90834 PSYTX W PT 45 MIN RHC	$191.67	$191.67	$90.67 – $191.67
Psychotherapy, 45 minutes: rates for 5 insurance plans Allegiance — All: $162.92 Blue Cross Blue Shield of Montana — All: $191.67 First Choice Health — All: $191.67 Montana Health CoOp — All: $191.67 Pacific Source — All: $90.67
Psychotherapy, 60 minutes CPT 90837 · Inpatient or outpatient · Hospital (facility) fee In the file: HC PR 90837 PSYCHOTHERAPY W/PATIENT 60 MINUTES	$81.12	$81.12	$68.95 – $132.89
Psychotherapy, 60 minutes: rates for 5 insurance plans Allegiance — All: $68.95 Blue Cross Blue Shield of Montana — All: $81.12 First Choice Health — All: $81.12 Montana Health CoOp — All: $81.12 Pacific Source — All: $132.89
Psychotherapy, 60 minutes CPT 90837 · Inpatient or outpatient · Hospital (facility) fee In the file: HC PR 90837 PSYTX W PT 60 MIN RHC	$286.68	$286.68	$132.89 – $286.67
Psychotherapy, 60 minutes: rates for 5 insurance plans Allegiance — All: $243.67 Blue Cross Blue Shield of Montana — All: $286.67 First Choice Health — All: $286.67 Montana Health CoOp — All: $286.67 Pacific Source — All: $132.89
Family psychotherapy, without the patient CPT 90846 · Inpatient or outpatient · Hospital (facility) fee In the file: HC PR 90846 FAMILY PSYCHOTHERAPY W/O PATIENT PRESENT 50 MINS	$81.12	$81.12	$68.95 – $97.59
Family psychotherapy, without the patient: rates for 5 insurance plans Allegiance — All: $68.95 Blue Cross Blue Shield of Montana — All: $81.12 First Choice Health — All: $81.12 Montana Health CoOp — All: $81.12 Pacific Source — All: $97.59
Family psychotherapy, without the patient CPT 90846 · Inpatient or outpatient · Hospital (facility) fee In the file: HC PR 90846 PSYTX FAMILY WO PT 50 MIN RHC	$232.44	$232.44	$97.59 – $232.44
Family psychotherapy, without the patient: rates for 5 insurance plans Allegiance — All: $197.57 Blue Cross Blue Shield of Montana — All: $232.44 First Choice Health — All: $232.44 Montana Health CoOp — All: $232.44 Pacific Source — All: $97.59
Family psychotherapy, with the patient CPT 90847 · Inpatient or outpatient · Hospital (facility) fee In the file: HC PR 90847 FAMILY PSYCHOTHERAPY W/PATIENT PRESENT 50 MINS	$81.12	$81.12	$68.95 – $101.40
Family psychotherapy, with the patient: rates for 5 insurance plans Allegiance — All: $68.95 Blue Cross Blue Shield of Montana — All: $81.12 First Choice Health — All: $81.12 Montana Health CoOp — All: $81.12 Pacific Source — All: $101.40
Family psychotherapy, with the patient CPT 90847 · Inpatient or outpatient · Hospital (facility) fee In the file: HC PR 90847 PSYTX FAMILY W PT 50 MIN RHC	$239.46	$239.46	$101.40 – $239.46
Family psychotherapy, with the patient: rates for 5 insurance plans Allegiance — All: $203.54 Blue Cross Blue Shield of Montana — All: $239.46 First Choice Health — All: $239.46 Montana Health CoOp — All: $239.46 Pacific Source — All: $101.40
Group psychotherapy CPT 90853 · Inpatient or outpatient · Hospital (facility) fee In the file: HC PR 90853 GROUP PSYCHOTHERAPY 120 MIN	$59.33	$59.33	$23.88 – $59.33
Group psychotherapy: rates for 5 insurance plans Allegiance — All: $50.43 Blue Cross Blue Shield of Montana — All: $59.33 First Choice Health — All: $59.33 Montana Health CoOp — All: $59.33 Pacific Source — All: $23.88
Group psychotherapy CPT 90853 · Inpatient or outpatient · Hospital (facility) fee In the file: HC PR 90853 PSYTX GROUP RHC	$59.33	$59.33	$23.88 – $59.33
Group psychotherapy: rates for 5 insurance plans Allegiance — All: $50.43 Blue Cross Blue Shield of Montana — All: $59.33 First Choice Health — All: $59.33 Montana Health CoOp — All: $59.33 Pacific Source — All: $23.88

Procedures and surgery

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Removal of breast growth (open surgery) CPT 19120 · Inpatient or outpatient · Hospital (facility) fee In the file: HC PR 19120 REMOVAL OF BREAST LESION 1 OR MORE LESIONS	$1,868.31	$1,868.31	$430.16 – $1,868.30
Removal of breast growth (open surgery): rates for 5 insurance plans Allegiance — All: $1,588.06 Blue Cross Blue Shield of Montana — All: $1,868.30 First Choice Health — All: $1,868.30 Montana Health CoOp — All: $1,868.30 Pacific Source — All: $430.16
Total hip replacement CPT 27130 · Inpatient or outpatient · Hospital (facility) fee In the file: HC PR 27130 TOTAL HIP ARTHROPLASTY	$8,066.92	$8,066.92	$1,315.73 – $8,066.91
Total hip replacement: rates for 5 insurance plans Allegiance — All: $6,856.87 Blue Cross Blue Shield of Montana — All: $8,066.91 First Choice Health — All: $8,066.91 Montana Health CoOp — All: $8,066.91 Pacific Source — All: $1,315.73
Total hip replacement CPT 27130 · Inpatient or outpatient · Hospital (facility) fee In the file: TOTAL HIP ARTHROPLASTY LEFT	$51,485.44	$51,485.44	$1,315.73 – $51,485.43
Total hip replacement: rates for 5 insurance plans Allegiance — All: $43,762.62 Blue Cross Blue Shield of Montana — All: $51,485.43 First Choice Health — All: $51,485.43 Montana Health CoOp — All: $51,485.43 Pacific Source — All: $1,315.73
Total knee replacement CPT 27447 · Inpatient or outpatient · Hospital (facility) fee In the file: HC PR 27447 TOTAL KNEE ARTHROPLASTY	$8,517.13	$8,517.13	$1,314.34 – $8,517.13
Total knee replacement: rates for 5 insurance plans Allegiance — All: $7,239.56 Blue Cross Blue Shield of Montana — All: $8,517.13 First Choice Health — All: $8,517.13 Montana Health CoOp — All: $8,517.13 Pacific Source — All: $1,314.34
Total knee replacement CPT 27447 · Inpatient or outpatient · Hospital (facility) fee In the file: LEFT/ RIGHT TOTAL KNEE - with Inpatient stay	$47,840	$47,840	$1,314.34 – $47,840
Total knee replacement: rates for 5 insurance plans Allegiance — All: $40,664 Blue Cross Blue Shield of Montana — All: $47,840 First Choice Health — All: $47,840 Montana Health CoOp — All: $47,840 Pacific Source — All: $1,314.34
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Inpatient or outpatient · Hospital (facility) fee In the file: HC PR 29826 ARTHROSCOPY SHOULDER W/CORACOACRM LIGMNT RELEASE	$3,340.27	$3,340.27	$176.49 – $3,340.27
Shoulder arthroscopy: shaving of shoulder bone: rates for 5 insurance plans Allegiance — All: $2,839.23 Blue Cross Blue Shield of Montana — All: $3,340.27 First Choice Health — All: $3,340.27 Montana Health CoOp — All: $3,340.27 Pacific Source — All: $176.49
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Inpatient or outpatient · Hospital (facility) fee In the file: R SHOULDER ARTHRO WITH SUBACROMIAL DECOMPRESSION w mini rotator cuff	$27,395.88	$27,395.88	$176.49 – $27,395.87
Shoulder arthroscopy: shaving of shoulder bone: rates for 5 insurance plans Allegiance — All: $23,286.49 Blue Cross Blue Shield of Montana — All: $27,395.87 First Choice Health — All: $27,395.87 Montana Health CoOp — All: $27,395.87 Pacific Source — All: $176.49
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Inpatient or outpatient · Hospital (facility) fee In the file: LEFT KNEE ARTHROSCOPY	$10,037.99	$10,037.99	$557.85 – $10,037.98
Knee arthroscopy: removal of torn cartilage (meniscus): rates for 5 insurance plans Allegiance — All: $8,532.28 Blue Cross Blue Shield of Montana — All: $10,037.98 First Choice Health — All: $10,037.98 Montana Health CoOp — All: $10,037.98 Pacific Source — All: $557.85
Removal of tonsils and adenoids (under age 12) CPT 42820 · Inpatient or outpatient · Hospital (facility) fee In the file: HC PR 42820 REMOVE TONSILS AND ADENOIDS < 12 YEARS	$1,263.76	$1,263.76	$297.96 – $1,263.75
Removal of tonsils and adenoids (under age 12): rates for 5 insurance plans Allegiance — All: $1,074.19 Blue Cross Blue Shield of Montana — All: $1,263.75 First Choice Health — All: $1,263.75 Montana Health CoOp — All: $1,263.75 Pacific Source — All: $297.96
Removal of tonsils and adenoids (under age 12) CPT 42820 · Inpatient or outpatient · Hospital (facility) fee In the file: tonsilectomy,adenoidect	$4,917.43	$4,917.43	$297.96 – $4,917.43
Removal of tonsils and adenoids (under age 12): rates for 5 insurance plans Allegiance — All: $4,179.81 Blue Cross Blue Shield of Montana — All: $4,917.43 First Choice Health — All: $4,917.43 Montana Health CoOp — All: $4,917.43 Pacific Source — All: $297.96
Upper GI endoscopy (diagnostic) CPT 43235 · Inpatient or outpatient · Hospital (facility) fee In the file: HC PR 43235 EGD DIAGNOSTIC BRUSH WASH	$795.70	$795.70	$124.24 – $795.70
Upper GI endoscopy (diagnostic): rates for 5 insurance plans Allegiance — All: $676.34 Blue Cross Blue Shield of Montana — All: $795.70 First Choice Health — All: $795.70 Montana Health CoOp — All: $795.70 Pacific Source — All: $124.24
Upper GI endoscopy with biopsy CPT 43239 · Inpatient or outpatient · Hospital (facility) fee In the file: EGD	$3,588	$3,588	$139.81 – $3,588
Upper GI endoscopy with biopsy: rates for 5 insurance plans Allegiance — All: $3,049.80 Blue Cross Blue Shield of Montana — All: $3,588 First Choice Health — All: $3,588 Montana Health CoOp — All: $3,588 Pacific Source — All: $139.81
Upper GI endoscopy with biopsy CPT 43239 · Inpatient or outpatient · Hospital (facility) fee In the file: EGD W COLONOSCOPY SCREEN	$5,304	$5,304	$139.81 – $5,304
Upper GI endoscopy with biopsy: rates for 5 insurance plans Allegiance — All: $4,508.40 Blue Cross Blue Shield of Montana — All: $5,304 First Choice Health — All: $5,304 Montana Health CoOp — All: $5,304 Pacific Source — All: $139.81
Upper GI endoscopy with biopsy CPT 43239 · Inpatient or outpatient · Hospital (facility) fee In the file: HC PR 43239 EGD BIOPSY SINGLE/MULTIPLE	$894.97	$894.97	$139.81 – $894.97
Upper GI endoscopy with biopsy: rates for 5 insurance plans Allegiance — All: $760.72 Blue Cross Blue Shield of Montana — All: $894.97 First Choice Health — All: $894.97 Montana Health CoOp — All: $894.97 Pacific Source — All: $139.81
Colonoscopy (diagnostic) CPT 45378 · Inpatient or outpatient · Hospital (facility) fee In the file: HC PR 45378 DIAGNOSTIC COLONOSCOPY	$1,633.32	$1,633.32	$186.87 – $1,633.32
Colonoscopy (diagnostic): rates for 5 insurance plans Allegiance — All: $1,388.32 Blue Cross Blue Shield of Montana — All: $1,633.32 First Choice Health — All: $1,633.32 Montana Health CoOp — All: $1,633.32 Pacific Source — All: $186.87
Colonoscopy with biopsy CPT 45380 · Inpatient or outpatient · Hospital (facility) fee In the file: HC PR 45380 COLONOSCOPY AND BIOPSY	$1,753.80	$1,753.80	$202.79 – $1,753.80
Colonoscopy with biopsy: rates for 5 insurance plans Allegiance — All: $1,490.73 Blue Cross Blue Shield of Montana — All: $1,753.80 First Choice Health — All: $1,753.80 Montana Health CoOp — All: $1,753.80 Pacific Source — All: $202.79
Colonoscopy with removal of polyps (snare) CPT 45385 · Inpatient or outpatient · Hospital (facility) fee In the file: HC PR 45385 LESION REMOVAL COLONOSCOPY, POLYP SNARE	$1,825.93	$1,825.93	$257.82 – $1,825.92
Colonoscopy with removal of polyps (snare): rates for 5 insurance plans Allegiance — All: $1,552.03 Blue Cross Blue Shield of Montana — All: $1,825.92 First Choice Health — All: $1,825.92 Montana Health CoOp — All: $1,825.92 Pacific Source — All: $257.82
Ultrasound of the lower bowel by endoscope CPT 45391 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COLONOSCOPY W/ENDOSCOPE US	Not listed in the file	Not listed in the file	$260.93
Ultrasound of the lower bowel by endoscope: rates for 5 insurance plans Pacific Source — All: $260.93 Allegiance — All: 85% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield of Montana — All: 100% (a percentage in the contract, not a dollar amount) First Choice Health — All: 100% (a percentage in the contract, not a dollar amount) Montana Health CoOp — All: 100% (a percentage in the contract, not a dollar amount)
Screening colonoscopy (not high risk) HCPCS G0121 · Inpatient or outpatient · Hospital (facility) fee In the file: COLONOSCOPY/W PROF FEES- SCREENING	$3,432	$3,432	$187.22 – $3,432
Screening colonoscopy (not high risk): rates for 5 insurance plans Allegiance — All: $2,917.20 Blue Cross Blue Shield of Montana — All: $3,432 First Choice Health — All: $3,432 Montana Health CoOp — All: $3,432 Pacific Source — All: $187.22
Screening colonoscopy (not high risk) HCPCS G0121 · Inpatient or outpatient · Hospital (facility) fee In the file: EGD W COLONOSCOPY SCREEN	$5,304	$5,304	$139.81 – $5,304
Screening colonoscopy (not high risk): rates for 5 insurance plans Allegiance — All: $4,508.40 Blue Cross Blue Shield of Montana — All: $5,304 First Choice Health — All: $5,304 Montana Health CoOp — All: $5,304 Pacific Source — All: $139.81
Screening colonoscopy (not high risk) HCPCS G0121 · Inpatient or outpatient · Hospital (facility) fee In the file: HC PR G0121 COLORECTAL SCRN; NOT HI RISK IND	$1,260.06	$1,260.06	$187.22 – $1,260.06
Screening colonoscopy (not high risk): rates for 5 insurance plans Allegiance — All: $1,071.05 Blue Cross Blue Shield of Montana — All: $1,260.06 First Choice Health — All: $1,260.06 Montana Health CoOp — All: $1,260.06 Pacific Source — All: $187.22
Gallbladder removal by laparoscope CPT 47562 · Inpatient or outpatient · Hospital (facility) fee In the file: HC PR 47562 LAPAROSCOPIC CHOLECYSTECTOMY	$3,878.32	$3,878.32	$683.82 – $3,878.31
Gallbladder removal by laparoscope: rates for 5 insurance plans Allegiance — All: $3,296.56 Blue Cross Blue Shield of Montana — All: $3,878.31 First Choice Health — All: $3,878.31 Montana Health CoOp — All: $3,878.31 Pacific Source — All: $683.82
Gallbladder removal by laparoscope CPT 47562 · Inpatient or outpatient · Hospital (facility) fee In the file: Laparoscopic Cholecystectomy	$16,640	$16,640	$683.82 – $16,640
Gallbladder removal by laparoscope: rates for 5 insurance plans Allegiance — All: $14,144 Blue Cross Blue Shield of Montana — All: $16,640 First Choice Health — All: $16,640 Montana Health CoOp — All: $16,640 Pacific Source — All: $683.82
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Inpatient or outpatient · Hospital (facility) fee In the file: EXCISION LEFT HYDROCELE WITH HERNIA	$12,116	$12,116	$541.93 – $12,116
Groin (inguinal) hernia repair, age 5 or older: rates for 5 insurance plans Allegiance — All: $10,298.60 Blue Cross Blue Shield of Montana — All: $12,116 First Choice Health — All: $12,116 Montana Health CoOp — All: $12,116 Pacific Source — All: $541.93
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Inpatient or outpatient · Hospital (facility) fee In the file: HC PR 49505 REPAIR INGUINAL HERNIA INITIAL BLOCK >5 YR REDUCIBLE	$2,337.71	$2,337.71	$541.93 – $2,337.71
Groin (inguinal) hernia repair, age 5 or older: rates for 5 insurance plans Allegiance — All: $1,987.05 Blue Cross Blue Shield of Montana — All: $2,337.71 First Choice Health — All: $2,337.71 Montana Health CoOp — All: $2,337.71 Pacific Source — All: $541.93
Prostate biopsy CPT 55700 · Inpatient or outpatient · Hospital (facility) fee In the file: HC PR 55700 BIOPSY OF PROSTATE	$770.80	$770.80	$130.81 – $770.79
Prostate biopsy: rates for 5 insurance plans Allegiance — All: $655.17 Blue Cross Blue Shield of Montana — All: $770.79 First Choice Health — All: $770.79 Montana Health CoOp — All: $770.79 Pacific Source — All: $130.81
Prostate removal by laparoscope (radical prostatectomy) CPT 55866 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LAPS SURG PRST8ECT RPBIC RAD	Not listed in the file	Not listed in the file	$1,454.84
Prostate removal by laparoscope (radical prostatectomy): rates for 5 insurance plans Pacific Source — All: $1,454.84 Allegiance — All: 85% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield of Montana — All: 100% (a percentage in the contract, not a dollar amount) First Choice Health — All: 100% (a percentage in the contract, not a dollar amount) Montana Health CoOp — All: 100% (a percentage in the contract, not a dollar amount)
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HYSTEROSCOPY BIOPSY	Not listed in the file	Not listed in the file	$235.32
Hysteroscopy with biopsy of the uterus lining: rates for 5 insurance plans Pacific Source — All: $235.32 Allegiance — All: 85% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield of Montana — All: 100% (a percentage in the contract, not a dollar amount) First Choice Health — All: 100% (a percentage in the contract, not a dollar amount) Montana Health CoOp — All: 100% (a percentage in the contract, not a dollar amount)
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: NJX INTERLAMINAR LMBR/SAC	Not listed in the file	Not listed in the file	$100.70
Spinal injection, lower back (epidural), with imaging guidance: rates for 5 insurance plans Pacific Source — All: $100.70 Allegiance — All: 85% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield of Montana — All: 100% (a percentage in the contract, not a dollar amount) First Choice Health — All: 100% (a percentage in the contract, not a dollar amount) Montana Health CoOp — All: 100% (a percentage in the contract, not a dollar amount)
Nerve root injection, lower back, with imaging guidance CPT 64483 · Inpatient or outpatient · Hospital (facility) fee In the file: ESI- LUMBAR	$2,036.32	$2,036.32	$112.82 – $2,036.32
Nerve root injection, lower back, with imaging guidance: rates for 5 insurance plans Allegiance — All: $1,730.87 Blue Cross Blue Shield of Montana — All: $2,036.32 First Choice Health — All: $2,036.32 Montana Health CoOp — All: $2,036.32 Pacific Source — All: $112.82
Carpal tunnel release CPT 64721 · Inpatient or outpatient · Hospital (facility) fee In the file: HC PR 64721 CARPAL TUNNEL SURGERY	$2,379	$2,379	$448.84 – $2,379
Carpal tunnel release: rates for 5 insurance plans Allegiance — All: $2,022.15 Blue Cross Blue Shield of Montana — All: $2,379 First Choice Health — All: $2,379 Montana Health CoOp — All: $2,379 Pacific Source — All: $448.84
Carpal tunnel release CPT 64721 · Inpatient or outpatient · Hospital (facility) fee In the file: RELEASE CARPAL TUNNEL BILAT	$8,537.77	$8,537.77	$448.84 – $8,537.76
Carpal tunnel release: rates for 5 insurance plans Allegiance — All: $7,257.10 Blue Cross Blue Shield of Montana — All: $8,537.76 First Choice Health — All: $8,537.76 Montana Health CoOp — All: $8,537.76 Pacific Source — All: $448.84
Laser treatment of clouding after cataract surgery CPT 66821 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: AFTER CATARACT LASER SURGERY	Not listed in the file	Not listed in the file	$312.84
Laser treatment of clouding after cataract surgery: rates for 5 insurance plans Pacific Source — All: $312.84 Allegiance — All: 85% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield of Montana — All: 100% (a percentage in the contract, not a dollar amount) First Choice Health — All: 100% (a percentage in the contract, not a dollar amount) Montana Health CoOp — All: 100% (a percentage in the contract, not a dollar amount)
Cataract removal with lens implant CPT 66984 · Inpatient or outpatient · Hospital (facility) fee In the file: HC CATARACT REMOVE W/IOL ETRACAPSULAR	$5,886.87	$5,886.87	$544.70 – $5,886.86
Cataract removal with lens implant: rates for 5 insurance plans Allegiance — All: $5,003.83 Blue Cross Blue Shield of Montana — All: $5,886.86 First Choice Health — All: $5,886.86 Montana Health CoOp — All: $5,886.86 Pacific Source — All: $544.70

Pregnancy and childbirth

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Vaginal delivery, with care before and after CPT 59400 · Inpatient or outpatient · Hospital (facility) fee In the file: HC PR 59400 TOTAL OB/VAGINAL DELIVERY/PP CARE	$5,433.38	$5,433.38	$2,460.15 – $5,433.37
Vaginal delivery, with care before and after: rates for 5 insurance plans Allegiance — All: $4,618.36 Blue Cross Blue Shield of Montana — All: $5,433.37 First Choice Health — All: $5,433.37 Montana Health CoOp — All: $5,433.37 Pacific Source — All: $2,460.15
Cesarean delivery (C-section), with care before and after CPT 59510 · Inpatient or outpatient · Hospital (facility) fee In the file: HC PR 59510 TOTAL OB/CESAREAN DELIVERY/PP CAR	$6,640.66	$6,640.66	$2,716.59 – $6,640.66
Cesarean delivery (C-section), with care before and after: rates for 5 insurance plans Allegiance — All: $5,644.56 Blue Cross Blue Shield of Montana — All: $6,640.66 First Choice Health — All: $6,640.66 Montana Health CoOp — All: $6,640.66 Pacific Source — All: $2,716.59
Vaginal delivery after a previous C-section, with care before and after CPT 59610 · Inpatient or outpatient · Hospital (facility) fee In the file: HC PR 59610 TOTAL OB/VBAC/PP CARE	$6,232.41	$6,232.41	$2,572.62 – $6,232.40
Vaginal delivery after a previous C-section, with care before and after: rates for 5 insurance plans Allegiance — All: $5,297.54 Blue Cross Blue Shield of Montana — All: $6,232.40 First Choice Health — All: $6,232.40 Montana Health CoOp — All: $6,232.40 Pacific Source — All: $2,572.62

Hospital stays (whole stay, MS-DRG)

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Heart valve or major heart-chest surgery with heart catheterization, with major complications MS-DRG 216 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITH MCC	Not listed in the file	Not listed in the file	Not listed in the file
Heart valve or major heart-chest surgery with heart catheterization, with major complications: rates for 5 insurance plans Allegiance — All: 85% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield of Montana — All: 100% (a percentage in the contract, not a dollar amount) First Choice Health — All: 100% (a percentage in the contract, not a dollar amount) Montana Health CoOp — All: 100% (a percentage in the contract, not a dollar amount) Pacific Source — All: 85% (a percentage in the contract, not a dollar amount)
Hip or knee replacement (major joint of the leg), without major complications MS-DRG 470 · Inpatient (hospital stay) · Hospital (facility) fee In the file: MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT MCC	Not listed in the file	Not listed in the file	Not listed in the file
Hip or knee replacement (major joint of the leg), without major complications: rates for 5 insurance plans Allegiance — All: 85% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield of Montana — All: 100% (a percentage in the contract, not a dollar amount) First Choice Health — All: 100% (a percentage in the contract, not a dollar amount) Montana Health CoOp — All: 100% (a percentage in the contract, not a dollar amount) Pacific Source — All: 85% (a percentage in the contract, not a dollar amount)
Neck (cervical) spinal fusion, without complications MS-DRG 473 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CERVICAL SPINAL FUSION WITHOUT CC/MCC	Not listed in the file	Not listed in the file	Not listed in the file
Neck (cervical) spinal fusion, without complications: rates for 5 insurance plans Allegiance — All: 85% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield of Montana — All: 100% (a percentage in the contract, not a dollar amount) First Choice Health — All: 100% (a percentage in the contract, not a dollar amount) Montana Health CoOp — All: 100% (a percentage in the contract, not a dollar amount) Pacific Source — All: 85% (a percentage in the contract, not a dollar amount)
Uterus and ovary surgery (not for cancer), without complications MS-DRG 743 · Inpatient (hospital stay) · Hospital (facility) fee In the file: UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITHOUT CC/MCC	Not listed in the file	Not listed in the file	Not listed in the file
Uterus and ovary surgery (not for cancer), without complications: rates for 5 insurance plans Allegiance — All: 85% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield of Montana — All: 100% (a percentage in the contract, not a dollar amount) First Choice Health — All: 100% (a percentage in the contract, not a dollar amount) Montana Health CoOp — All: 100% (a percentage in the contract, not a dollar amount) Pacific Source — All: 85% (a percentage in the contract, not a dollar amount)

Source: Clark Fork Valley Hospital’s standard charges file (linkprotect.cudasvc.com, CSV, CMS template 3.0.0; it can be a very large file), last updated by the hospital on March 29, 2026; retrieved November 1, 2026. The hospital’s price transparency page →

Found through the hospital’s cms-hpt.txt file, as required by the federal hospital price transparency rule (CMS). We show a selection of common services; the file has every item and service.

Hospital information

Hospital type	Critical Access Hospital
Address	10 Kruger Rd, Plains, MT 59859
County	Sanders County
State	Montana
Phone	(406) 826‑4800
Emergency services	Yes
Ownership	Voluntary non-profit - Private
Medicare overall rating	Not rated by CMS
CMS Certification Number	271323
Name in Medicare records	CLARK FORK VALLEY HOSPITAL
Profile level	Medicare data + hospital website
Official website	cfvh.org
Corrections	Report an error or suggest an update →

Sources

Hospital General Information — Centers for Medicare & Medicaid Services (CMS), data updated 2026-10-26, retrieved 2026-11-13
Medicare Care Compare — official Medicare profile of this hospital
U.S. Census Bureau Geocoder — map position used for distances

From the hospital’s website

Numbers match the citations above. Checked 2026-10-31.

Home | Clark Fork Valley Hospital — cfvh.org
DAISY/Sunflower Awards | Clark Fork Valley Hospital — cfvh.org
Emergency Medicine | Clark Fork Valley Hospital — cfvh.org
Visiting Nurse Services — cfvh.org
Cardiology | Clark Fork Valley Hospital — cfvh.org
Cardiopulmonary | Clark Fork Valley Hospital — cfvh.org
Imaging | Clark Fork Valley Hospital — cfvh.org
Neurology | Clark Fork Valley Hospital — cfvh.org
Orthopedics | Clark Fork Valley Hospital — cfvh.org
Surgical Services | Clark Fork Valley Hospital — cfvh.org

Clark Fork Valley Hospital

Summary

Profile from official sources

At a glance