Does Fallon Medical Complex Hospital have an emergency room?

Yes. Medicare (CMS) data lists emergency services at Fallon Medical Complex Hospital. In a medical emergency, call 911.

Where is Fallon Medical Complex Hospital?

202 S 4th St W, Baker, MT 59313, in Fallon County, Montana.

What is the phone number of Fallon Medical Complex Hospital?

(406) 778-3331, as listed by Medicare (CMS).

What is the Medicare star rating of Fallon Medical Complex 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.

Fallon Medical Complex Hospital — Phone, Address & ER

Quick answers

Does Fallon Medical Complex Hospital have an emergency room?: Yes. Medicare (CMS) data lists emergency services at Fallon Medical Complex Hospital. In a medical emergency, call 911.
Where is Fallon Medical Complex Hospital?: 202 S 4th St W, Baker, MT 59313, in Fallon County, Montana.
What is the phone number of Fallon Medical Complex Hospital?: (406) 778-3331, as listed by Medicare (CMS).
What is the Medicare star rating of Fallon Medical Complex 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^[5][6][8]

Physical and occupational therapy
Telemedicine
Radiology
Laboratory
Family practice
Physical therapy

Treatments^[4][9][12]

MRI
CT scan
Mammography
Ultrasound
Electrocardiogram (ECG/EKG)
Laboratory testing

Programs and centers^[5][7]

Swing bed long-term care
Home health
Discharge planning

Emergency care (hospital website)^{[4][5][8][12]}

Emergency room	Yes
Open 24/7	Yes

Visiting and practical information

Patient portal	Patient Portal

Recognition^[9]

FDA and ACR accredited facility (diagnostic imaging)

Doctors and clinicians (23)

23 doctors and other clinicians list Fallon Medical Complex 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

Other emergency rooms nearby

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

Dahl Memorial Healthcare Association Inc30 mi · Ekalaka, MT · Critical Access Hospital
Southwest Healthcare Services39 mi · Bowman, ND · Critical Access Hospital
Glendive Medical Center64 mi · Glendive, MT · Critical Access Hospital
Prairie Community CAH64 mi · Terry, MT · Critical Access Hospital
Holy Rosary Hospital77 mi · Miles City, MT · Critical Access Hospital

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

Other hospitals near Baker

West River Regional Medical Center78 mi · Hettinger, ND · Critical Access Hospital

Hospitals in Fallon County · Hospitals near me

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

Community Clinic0.0 mi · Baker, MT · Rural health clinic

Pharmacies

Baker Drug0.0 mi · Baker, 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 Fallon Medical Complex 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.

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)	16.8%
Not reported to Medicare	Readmitted within 30 days: coronary bypass surgery; Readmitted within 30 days: hip or knee replacement
Too few cases to report	Readmitted within 30 days: heart attack; Readmitted within 30 days: heart failure; Readmitted within 30 days: pneumonia; Readmitted within 30 days: COPD

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)	96 minutesNational average: 162 minutes
Patients who left the emergency room before being seen (OP-22)	0%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: the patient survey, infections caught in the hospital, complications and deaths. 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 86 common services exactly as Fallon Medical Complex 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 →

$ 33 amounts are marked with “!”: they are more than 100 times higher or lower than what other hospitals list for the same service, which usually means an error or a different unit in the hospital’s file. They are shown exactly as listed; ask the hospital before relying on them.

Show the prices of 86 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: OFFICE VISIT NEW PT-LEVEL 3 (30-44MINS)	$240	$240	$37.85 – $240
New patient office visit (about 30–44 minutes): 10 of 15 insurance plan rates Allegiance — All: $128.30 Blue Cross Blue Shield — All: $128.30 Blue Cross Blue Shield — Medicare Advantage: $37.85 Coventry — All: $228 First Choice Health — All: $131.56 First Health Network — All: $228 Humana — Medicare Advantage: $37.85 Interwest Health — All: $204 Montana Health CoOp — All: $232.80 Pacific Source — All: $240
New patient office visit (about 45–59 minutes) CPT 99204 · Inpatient or outpatient · Hospital (facility) fee In the file: OFFICE VISIT NEW PT-LEVEL 4 (45-59MINS)	$328	$328	$208.74 – $328
New patient office visit (about 45–59 minutes): 10 of 15 insurance plan rates Allegiance — All: $208.74 Blue Cross Blue Shield — All: $208.74 Blue Cross Blue Shield — Medicare Advantage: $328 Coventry — All: $311.60 First Choice Health — All: $212.98 First Health Network — All: $311.60 Humana — Medicare Advantage: $328 Interwest Health — All: $278.80 Montana Health CoOp — All: $318.16 Pacific Source — All: $328
New patient office visit (about 60–74 minutes) CPT 99205 · Inpatient or outpatient · Hospital (facility) fee In the file: OFFICE VISIT NEW PT-LEVEL 5 (60-74MINS)	$466	$466	$283.93 – $466
New patient office visit (about 60–74 minutes): 10 of 15 insurance plan rates Allegiance — All: $283.93 Blue Cross Blue Shield — All: $283.93 Blue Cross Blue Shield — Medicare Advantage: $466 Coventry — All: $442.70 First Choice Health — All: $289.01 First Health Network — All: $442.70 Humana — Medicare Advantage: $466 Interwest Health — All: $396.10 Montana Health CoOp — All: $452.02 Pacific Source — All: $466
Established patient office visit (about 20–29 minutes) CPT 99213 · Inpatient or outpatient · Hospital (facility) fee In the file: OFFICE VISIT EST PT-LEVEL 2 or 20-29MINS	$168	$168	$17.14 – $168
Established patient office visit (about 20–29 minutes): 10 of 15 insurance plan rates Allegiance — All: $103.06 Blue Cross Blue Shield — All: $103.06 Blue Cross Blue Shield — Medicare Advantage: $17.14 Coventry — All: $159.60 First Choice Health — All: $105.14 First Health Network — All: $159.60 Humana — Medicare Advantage: $17.14 Interwest Health — All: $142.80 Montana Health CoOp — All: $162.96 Pacific Source — All: $168
Established patient office visit (about 20–29 minutes) CPT 99213 · Inpatient or outpatient · Hospital (facility) fee · modifier EI In the file: E&M OR OP VISIT-LEVEL 2 OR 20-29MINS	$173	$173	Not listed in the file
Established patient office visit (about 20–29 minutes) CPT 99213 · Inpatient or outpatient · Hospital (facility) fee · modifier SM In the file: OP PHY E&M VISIT-LEVEL 2 OR 20-29MINS	$173	$173	Not listed in the file
Established patient office visit (about 30–39 minutes) CPT 99214 · Inpatient or outpatient · Hospital (facility) fee In the file: OFFICE VISIT EST PT-LEVEL 3 or 30-39MINS	$244	$244	$9.06 – $244
Established patient office visit (about 30–39 minutes): 10 of 15 insurance plan rates Allegiance — All: $151.96 Blue Cross Blue Shield — All: $151.96 Blue Cross Blue Shield — Medicare Advantage: $9.06 Coventry — All: $231.80 First Choice Health — All: $154.21 First Health Network — All: $231.80 Humana — Medicare Advantage: $9.06 Interwest Health — All: $207.40 Montana Health CoOp — All: $236.68 Pacific Source — All: $244
Established patient office visit (about 30–39 minutes) CPT 99214 · Inpatient or outpatient · Hospital (facility) fee · modifier EH In the file: E&M OR OP VISIT-LEVEL 3 OR 30-39MINS	$253	$253	Not listed in the file
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	$137.76 – $213.30
Office consultation with a specialist (moderate): 10 of 14 insurance plan rates Allegiance — All: $137.76 First Choice Health — All: $148.82 UHC — All: $213.30 Blue Cross Blue Shield — Medicare Advantage: 100% (a percentage in the contract, not a dollar amount) Coventry — All: 95% (a percentage in the contract, not a dollar amount) First Health Network — All: 95% (a percentage in the contract, not a dollar amount) Humana — Medicare Advantage: 100% (a percentage in the contract, not a dollar amount) Interwest Health — All: 85% (a percentage in the contract, not a dollar amount) Montana Health CoOp — All: 97% (a percentage in the contract, not a dollar amount) Pacific Source — 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	$209.79 – $319.66
Office consultation with a specialist (moderate to high): 10 of 14 insurance plan rates Allegiance — All: $209.79 First Choice Health — All: $237.79 UHC — All: $319.66 Blue Cross Blue Shield — Medicare Advantage: 100% (a percentage in the contract, not a dollar amount) Coventry — All: 95% (a percentage in the contract, not a dollar amount) First Health Network — All: 95% (a percentage in the contract, not a dollar amount) Humana — Medicare Advantage: 100% (a percentage in the contract, not a dollar amount) Interwest Health — All: 85% (a percentage in the contract, not a dollar amount) Montana Health CoOp — All: 97% (a percentage in the contract, not a dollar amount) Pacific Source — 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: DOT PHYSICAL NEW PATIENT 18-39YRS	$234	$234	$51.75 – $234
Preventive checkup, new patient, age 18–39: 10 of 15 insurance plan rates Allegiance — All: $146.17 Blue Cross Blue Shield — All: $146.17 Blue Cross Blue Shield — Medicare Advantage: $51.75 Coventry — All: $222.30 First Choice Health — All: $152.59 First Health Network — All: $222.30 Humana — Medicare Advantage: $51.75 Interwest Health — All: $198.90 Montana Health CoOp — All: $226.98 Pacific Source — All: $234
Preventive checkup, new patient, age 18–39 CPT 99385 · Inpatient or outpatient · Hospital (facility) fee In the file: DOT&FAA PHYSICAL NEW PATIENT 18-39YRS	$249	$249	$51.75 – $249
Preventive checkup, new patient, age 18–39: 10 of 15 insurance plan rates Allegiance — All: $146.17 Blue Cross Blue Shield — All: $146.17 Blue Cross Blue Shield — Medicare Advantage: $51.75 Coventry — All: $236.55 First Choice Health — All: $152.59 First Health Network — All: $236.55 Humana — Medicare Advantage: $51.75 Interwest Health — All: $211.65 Montana Health CoOp — All: $241.53 Pacific Source — All: $249
Preventive checkup, new patient, age 18–39 CPT 99385 · Inpatient or outpatient · Hospital (facility) fee In the file: FAA PHYSICAL NEW PATIENT 18-39YRS	$222	$222	$51.75 – $229.21
Preventive checkup, new patient, age 18–39: 10 of 15 insurance plan rates Allegiance — All: $146.17 Blue Cross Blue Shield — All: $146.17 Blue Cross Blue Shield — Medicare Advantage: $51.75 Coventry — All: $210.90 First Choice Health — All: $152.59 First Health Network — All: $210.90 Humana — Medicare Advantage: $51.75 Interwest Health — All: $188.70 Montana Health CoOp — All: $215.34 Pacific Source — All: $222
Preventive checkup, new patient, age 40–64 CPT 99386 · Inpatient or outpatient · Hospital (facility) fee In the file: DOT PHYSICAL NEW PATIENT 40-64YRS	$234	$234	$86.04 – $265.26
Preventive checkup, new patient, age 40–64: 10 of 15 insurance plan rates Allegiance — All: $177.19 Blue Cross Blue Shield — All: $177.19 Blue Cross Blue Shield — Medicare Advantage: $86.04 Coventry — All: $222.30 First Choice Health — All: $184.95 First Health Network — All: $222.30 Humana — Medicare Advantage: $86.04 Interwest Health — All: $198.90 Montana Health CoOp — All: $226.98 Pacific Source — All: $234
Preventive checkup, new patient, age 40–64 CPT 99386 · Inpatient or outpatient · Hospital (facility) fee In the file: DOT&FAA PHYSICAL NEW PATIENT 40-64YRS	$249	$249	$86.04 – $265.26
Preventive checkup, new patient, age 40–64: 10 of 15 insurance plan rates Allegiance — All: $177.19 Blue Cross Blue Shield — All: $177.19 Blue Cross Blue Shield — Medicare Advantage: $86.04 Coventry — All: $236.55 First Choice Health — All: $184.95 First Health Network — All: $236.55 Humana — Medicare Advantage: $86.04 Interwest Health — All: $211.65 Montana Health CoOp — All: $241.53 Pacific Source — All: $249
Preventive checkup, new patient, age 40–64 CPT 99386 · Inpatient or outpatient · Hospital (facility) fee In the file: FAA PHYSICAL NEW PATIENT 40-64YRS	$222	$222	$86.04 – $265.26
Preventive checkup, new patient, age 40–64: 10 of 15 insurance plan rates Allegiance — All: $177.19 Blue Cross Blue Shield — All: $177.19 Blue Cross Blue Shield — Medicare Advantage: $86.04 Coventry — All: $210.90 First Choice Health — All: $184.95 First Health Network — All: $210.90 Humana — Medicare Advantage: $86.04 Interwest Health — All: $188.70 Montana Health CoOp — All: $215.34 Pacific Source — All: $222
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EMERGENCY DEPT VISIT LOW MDM	Not listed in the file	Not listed in the file	$6.15 – $113.77
Emergency room visit (moderate): 10 of 15 insurance plan rates Allegiance — All: $110.94 Blue Cross Blue Shield — All: $110.94 Blue Cross Blue Shield — Medicare Advantage: $6.15 First Choice Health — All: $113.77 Humana — Medicare Advantage: $6.15 Tricare — All: $6.15 UHC — All: $112.45 UHC — Medicare Advantage: $6.15 VA Health — All: $6.15 Coventry — All: 95% (a percentage in the contract, not a dollar amount)
Emergency room visit (moderate) CPT 99283 · Inpatient or outpatient · Hospital (facility) fee · modifier 36 In the file: ER FACILITY E&M-MODERATE PROBLEM(S)	$554	$554	Not listed in the file
Emergency room visit (moderate) CPT 99283 · Inpatient or outpatient · Hospital (facility) fee · modifier SL In the file: ER PHYS E&M LEVEL 3-MODERATE PROBLEM(S)	$228	$228	Not listed in the file
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EMERGENCY DEPT VISIT MOD MDM	Not listed in the file	Not listed in the file	$24.26 – $206.58
Emergency room visit (moderately high): 10 of 15 insurance plan rates Allegiance — All: $188.76 Blue Cross Blue Shield — All: $188.76 Blue Cross Blue Shield — Medicare Advantage: $24.26 First Choice Health — All: $191.96 Humana — Medicare Advantage: $24.26 Tricare — All: $24.26 UHC — All: $206.58 UHC — Medicare Advantage: $24.26 VA Health — All: $24.26 Coventry — All: 95% (a percentage in the contract, not a dollar amount)
Emergency room visit (moderately high) CPT 99284 · Inpatient or outpatient · Hospital (facility) fee · modifier 36 In the file: ER FACILITY E&M-COMP/URGENT PROB(S)	$912	$912	Not listed in the file
Emergency room visit (moderately high) CPT 99284 · Inpatient or outpatient · Hospital (facility) fee · modifier SL In the file: ER PHYS E&M LEVEL 4 -COMP/URGENT PROB(S)	$390	$390	Not listed in the file
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EMERGENCY DEPT VISIT HI MDM	Not listed in the file	Not listed in the file	$45.29 – $300.10
Emergency room visit (high): 10 of 15 insurance plan rates Allegiance — All: $273.42 Blue Cross Blue Shield — All: $273.42 Blue Cross Blue Shield — Medicare Advantage: $45.29 First Choice Health — All: $278.77 Humana — Medicare Advantage: $45.29 Tricare — All: $45.29 UHC — All: $300.10 UHC — Medicare Advantage: $45.29 VA Health — All: $45.29 Coventry — All: 95% (a percentage in the contract, not a dollar amount)
Emergency room visit (high) CPT 99285 · Inpatient or outpatient · Hospital (facility) fee · modifier 36 In the file: ER FACILITY E&M-SEVERE/THREATENING PROBS	$1,477	$1,477	Not listed in the file
Emergency room visit (high) CPT 99285 · Inpatient or outpatient · Hospital (facility) fee · modifier SL In the file: ER PHY E&M LEVEL 5-SEVERE/THREATEN PROB	$598	$598	Not listed in the file

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: BASIC METABOLIC PANEL	$82	$82	$7.61 – $82
Basic metabolic panel (blood test): 10 of 15 insurance plan rates Allegiance — All: $11.87 Blue Cross Blue Shield — All: $82 Blue Cross Blue Shield — Medicare Advantage: $82 Coventry — All: $77.90 First Choice Health — All: $7.61 First Health Network — All: $77.90 Humana — Medicare Advantage: $82 Interwest Health — All: $69.70 Montana Health CoOp — All: $79.54 Pacific Source — All: $82
Comprehensive metabolic panel (blood test) CPT 80053 · Inpatient or outpatient · Hospital (facility) fee In the file: COMPREHENSIVE METABOLIC PANEL	$166	$166	$0.65 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $166
Comprehensive metabolic panel (blood test): 10 of 15 insurance plan rates Allegiance — All: $15.19 Blue Cross Blue Shield — All: $166 Blue Cross Blue Shield — Medicare Advantage: $0.65 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) Coventry — All: $157.70 First Choice Health — All: $9.50 First Health Network — All: $157.70 Humana — Medicare Advantage: $0.65 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) Interwest Health — All: $141.10 Montana Health CoOp — All: $161.02 Pacific Source — All: $166
Obstetric blood test panel CPT 80055 · Inpatient or outpatient · Hospital (facility) fee In the file: OBSTETRIC PANEL BC	$540	$540	$43.03 – $540
Obstetric blood test panel: 10 of 15 insurance plan rates Allegiance — All: $68.37 Blue Cross Blue Shield — All: $540 Blue Cross Blue Shield — Medicare Advantage: $65.99 Coventry — All: $513 First Choice Health — All: $43.03 First Health Network — All: $513 Humana — Medicare Advantage: $65.99 Interwest Health — All: $459 Montana Health CoOp — All: $523.80 Pacific Source — All: $540
Cholesterol panel (lipid panel) CPT 80061 · Inpatient or outpatient · Hospital (facility) fee In the file: LIPID PANEL	$122	$122	$12.05 – $122
Cholesterol panel (lipid panel): 10 of 15 insurance plan rates Allegiance — All: $18.99 Blue Cross Blue Shield — All: $122 Blue Cross Blue Shield — Medicare Advantage: $65.34 Coventry — All: $115.90 First Choice Health — All: $12.05 First Health Network — All: $115.90 Humana — Medicare Advantage: $65.34 Interwest Health — All: $103.70 Montana Health CoOp — All: $118.34 Pacific Source — All: $122
Kidney function panel CPT 80069 · Inpatient or outpatient · Hospital (facility) fee In the file: RENAL FUNCTION PANEL	$122	$122	$0.65 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $122
Kidney function panel: 10 of 15 insurance plan rates Allegiance — All: $12.34 Blue Cross Blue Shield — All: $122 Blue Cross Blue Shield — Medicare Advantage: $0.65 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) Coventry — All: $115.90 First Choice Health — All: $7.81 First Health Network — All: $115.90 Humana — Medicare Advantage: $0.65 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) Interwest Health — All: $103.70 Montana Health CoOp — All: $118.34 Pacific Source — All: $122
Liver function panel CPT 80076 · Inpatient or outpatient · Hospital (facility) fee In the file: HEPATIC FUNCTION PANEL	$110	$110	$7.35 – $110
Liver function panel: 10 of 15 insurance plan rates Allegiance — All: $11.87 Blue Cross Blue Shield — All: $110 Blue Cross Blue Shield — Medicare Advantage: $65.02 Coventry — All: $104.50 First Choice Health — All: $7.35 First Health Network — All: $104.50 Humana — Medicare Advantage: $65.02 Interwest Health — All: $93.50 Montana Health CoOp — All: $106.70 Pacific Source — All: $110
Urine test (automated, with microscope) CPT 81001 · Inpatient or outpatient · Hospital (facility) fee In the file: .UA W MICRO CHG	$76	$76	$2.85 – $76
Urine test (automated, with microscope): 10 of 15 insurance plan rates Allegiance — All: $4.75 Blue Cross Blue Shield — All: $76 Blue Cross Blue Shield — Medicare Advantage: $76 Coventry — All: $72.20 First Choice Health — All: $2.85 First Health Network — All: $72.20 Humana — Medicare Advantage: $76 Interwest Health — All: $64.60 Montana Health CoOp — All: $73.72 Pacific Source — All: $76
Urine test (manual, without microscope) CPT 81002 · Inpatient or outpatient · Hospital (facility) fee In the file: UA MANUAL DIPSTICK W/O MICRO	$33	$33	$3.13 – $33
Urine test (manual, without microscope): 10 of 15 insurance plan rates Allegiance — All: $4.75 Blue Cross Blue Shield — All: $33 Blue Cross Blue Shield — Medicare Advantage: $33 Coventry — All: $31.35 First Choice Health — All: $3.13 First Health Network — All: $31.35 Humana — Medicare Advantage: $33 Interwest Health — All: $28.05 Montana Health CoOp — All: $32.01 Pacific Source — All: $33
Urine test (manual, without microscope) CPT 81002 · Inpatient or outpatient · Hospital (facility) fee In the file: URINALYSIS-DIPSTK-NURSE	$38	$38	$3.13 – $38
Urine test (manual, without microscope): 10 of 15 insurance plan rates Allegiance — All: $4.75 Blue Cross Blue Shield — All: $38 Blue Cross Blue Shield — Medicare Advantage: $38 Coventry — All: $36.10 First Choice Health — All: $3.13 First Health Network — All: $36.10 Humana — Medicare Advantage: $38 Interwest Health — All: $32.30 Montana Health CoOp — All: $36.86 Pacific Source — All: $38
Urine test (automated, without microscope) CPT 81003 · Inpatient or outpatient · Hospital (facility) fee In the file: .UA DIP CHG	$40	$40	$2.03 – $40
Urine test (automated, without microscope): 10 of 15 insurance plan rates Allegiance — All: $3.32 Blue Cross Blue Shield — All: $40 Blue Cross Blue Shield — Medicare Advantage: $40 Coventry — All: $38 First Choice Health — All: $2.03 First Health Network — All: $38 Humana — Medicare Advantage: $40 Interwest Health — All: $34 Montana Health CoOp — All: $38.80 Pacific Source — All: $40
PSA (prostate specific antigen) blood test CPT 84153 · Inpatient or outpatient · Hospital (facility) fee In the file: PSA DIAGNOSTIC	$79	$79	$16.55 – $79
PSA (prostate specific antigen) blood test: 10 of 15 insurance plan rates Allegiance — All: $26.11 Blue Cross Blue Shield — All: $79 Blue Cross Blue Shield — Medicare Advantage: $79 Coventry — All: $75.05 First Choice Health — All: $16.55 First Health Network — All: $75.05 Humana — Medicare Advantage: $79 Interwest Health — All: $67.15 Montana Health CoOp — All: $76.63 Pacific Source — All: $79
PSA (prostate specific antigen) blood test CPT 84153 · Inpatient or outpatient · Hospital (facility) fee In the file: PSA TOTAL	$78	$78	$16.55 – $78
PSA (prostate specific antigen) blood test: 10 of 15 insurance plan rates Allegiance — All: $26.11 Blue Cross Blue Shield — All: $78 Blue Cross Blue Shield — Medicare Advantage: $78 Coventry — All: $74.10 First Choice Health — All: $16.55 First Health Network — All: $74.10 Humana — Medicare Advantage: $78 Interwest Health — All: $66.30 Montana Health CoOp — All: $75.66 Pacific Source — All: $78
Thyroid stimulating hormone (TSH) test CPT 84443 · Inpatient or outpatient · Hospital (facility) fee In the file: TSH	$109	$109	$15.12 – $109
Thyroid stimulating hormone (TSH) test: 10 of 15 insurance plan rates Allegiance — All: $23.74 Blue Cross Blue Shield — All: $109 Blue Cross Blue Shield — Medicare Advantage: $109 Coventry — All: $103.55 First Choice Health — All: $15.12 First Health Network — All: $103.55 Humana — Medicare Advantage: $109 Interwest Health — All: $92.65 Montana Health CoOp — All: $105.73 Pacific Source — All: $109
Complete blood count (CBC) with differential CPT 85025 · Inpatient or outpatient · Hospital (facility) fee In the file: CBC W/ AUTO DIFFERENTIAL	$87	$87	$6.99 – $87
Complete blood count (CBC) with differential: 10 of 15 insurance plan rates Allegiance — All: $10.92 Blue Cross Blue Shield — All: $87 Blue Cross Blue Shield — Medicare Advantage: $87 Coventry — All: $82.65 First Choice Health — All: $6.99 First Health Network — All: $82.65 Humana — Medicare Advantage: $87 Interwest Health — All: $73.95 Montana Health CoOp — All: $84.39 Pacific Source — All: $87
Complete blood count (CBC), automated CPT 85027 · Inpatient or outpatient · Hospital (facility) fee In the file: CBC NO DIFFERENTIAL	$55	$55	$5.82 – $55
Complete blood count (CBC), automated: 10 of 15 insurance plan rates Allegiance — All: $9.02 Blue Cross Blue Shield — All: $55 Blue Cross Blue Shield — Medicare Advantage: $55 Coventry — All: $52.25 First Choice Health — All: $5.82 First Health Network — All: $52.25 Humana — Medicare Advantage: $55 Interwest Health — All: $46.75 Montana Health CoOp — All: $53.35 Pacific Source — All: $55
Blood clotting time test (prothrombin time, PT) CPT 85610 · Inpatient or outpatient · Hospital (facility) fee In the file: POC PT/INR	$44	$44	$3.86 – $44
Blood clotting time test (prothrombin time, PT): 10 of 15 insurance plan rates Allegiance — All: $6.17 Blue Cross Blue Shield — All: $44 Blue Cross Blue Shield — Medicare Advantage: $24.91 Coventry — All: $41.80 First Choice Health — All: $3.86 First Health Network — All: $41.80 Humana — Medicare Advantage: $24.91 Interwest Health — All: $37.40 Montana Health CoOp — All: $42.68 Pacific Source — All: $44
Blood clotting time test (prothrombin time, PT) CPT 85610 · Inpatient or outpatient · Hospital (facility) fee In the file: PROTIME	$44	$44	$3.86 – $44
Blood clotting time test (prothrombin time, PT): 10 of 15 insurance plan rates Allegiance — All: $6.17 Blue Cross Blue Shield — All: $44 Blue Cross Blue Shield — Medicare Advantage: $24.91 Coventry — All: $41.80 First Choice Health — All: $3.86 First Health Network — All: $41.80 Humana — Medicare Advantage: $24.91 Interwest Health — All: $37.40 Montana Health CoOp — All: $42.68 Pacific Source — All: $44
Blood clotting time test (prothrombin time, PT) CPT 85610 · Inpatient or outpatient · Hospital (facility) fee In the file: PT	$42	$42	$3.86 – $42
Blood clotting time test (prothrombin time, PT): 10 of 15 insurance plan rates Allegiance — All: $6.17 Blue Cross Blue Shield — All: $42 Blue Cross Blue Shield — Medicare Advantage: $24.91 Coventry — All: $39.90 First Choice Health — All: $3.86 First Health Network — All: $39.90 Humana — Medicare Advantage: $24.91 Interwest Health — All: $35.70 Montana Health CoOp — All: $40.74 Pacific Source — All: $42
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Inpatient or outpatient · Hospital (facility) fee In the file: PTT	$113	$113	$5.41 – $113
Blood clotting test (partial thromboplastin time, PTT): 10 of 15 insurance plan rates Allegiance — All: $8.55 Blue Cross Blue Shield — All: $113 Blue Cross Blue Shield — Medicare Advantage: $113 Coventry — All: $107.35 First Choice Health — All: $5.41 First Health Network — All: $107.35 Humana — Medicare Advantage: $113 Interwest Health — All: $96.05 Montana Health CoOp — All: $109.61 Pacific Source — All: $113

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: CT HEAD WO	$1,433	$1,433	$18.44 – $1,433
CT scan of the head or brain, without contrast: 10 of 15 insurance plan rates Allegiance — All: $171.41 Blue Cross Blue Shield — All: $171.41 Blue Cross Blue Shield — Medicare Advantage: $18.44 Coventry — All: $1,361.35 First Choice Health — All: $176.32 First Health Network — All: $1,361.35 Humana — Medicare Advantage: $18.44 Interwest Health — All: $1,218.05 Montana Health CoOp — All: $1,390.01 Pacific Source — All: $1,433
CT scan of the head or brain, without contrast CPT 70450 · Inpatient or outpatient · Hospital (facility) fee · modifier SD In the file: PHY HEAD CT WO CONTRAST	$163	$163	Not listed in the file
MRI of the brain, before and after contrast CPT 70553 · Inpatient or outpatient · Hospital (facility) fee In the file: MRI BRAIN W WO CONTRAST	$3,127	$3,127	$73.43 – $3,127
MRI of the brain, before and after contrast: 10 of 15 insurance plan rates Allegiance — All: $516.34 Blue Cross Blue Shield — All: $516.34 Blue Cross Blue Shield — Medicare Advantage: $73.43 Coventry — All: $2,970.65 First Choice Health — All: $539.74 First Health Network — All: $2,970.65 Humana — Medicare Advantage: $73.43 Interwest Health — All: $2,657.95 Montana Health CoOp — All: $3,033.19 Pacific Source — All: $3,127
MRI of the brain, before and after contrast CPT 70553 · Inpatient or outpatient · Hospital (facility) fee · modifier SD In the file: PHY BRAIN W/WO CONTRAST MRI	$357	$357	Not listed in the file
Chest X-ray, 2 views CPT 71046 · Inpatient or outpatient · Hospital (facility) fee In the file: XR CHEST 2V	$320	$320	$50.14 – $320
Chest X-ray, 2 views: 10 of 15 insurance plan rates Allegiance — All: $53.11 Blue Cross Blue Shield — All: $53.11 Blue Cross Blue Shield — Medicare Advantage: $50.14 Coventry — All: $304 First Choice Health — All: $53.92 First Health Network — All: $304 Humana — Medicare Advantage: $50.14 Interwest Health — All: $272 Montana Health CoOp — All: $310.40 Pacific Source — All: $320
Chest X-ray, 2 views CPT 71046 · Inpatient or outpatient · Hospital (facility) fee · modifier SD In the file: PHY CHEST 2V XRAY	$43	$43	Not listed in the file
X-ray of the lower spine, at least 4 views CPT 72110 · Inpatient or outpatient · Hospital (facility) fee In the file: XR L SPINE COMP MIN 4V	$391	$391	$6.79 – $391
X-ray of the lower spine, at least 4 views: 10 of 15 insurance plan rates Allegiance — All: $82.02 Blue Cross Blue Shield — All: $82.02 Blue Cross Blue Shield — Medicare Advantage: $6.79 Coventry — All: $371.45 First Choice Health — All: $82.50 First Health Network — All: $371.45 Humana — Medicare Advantage: $6.79 Interwest Health — All: $332.35 Montana Health CoOp — All: $379.27 Pacific Source — All: $391
X-ray of the lower spine, at least 4 views CPT 72110 · Inpatient or outpatient · Hospital (facility) fee · modifier SD In the file: PHY L-SPINE (C) MIN 4V XRAY	$66	$66	Not listed in the file
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Inpatient or outpatient · Hospital (facility) fee In the file: MRI L SPINE WO CONTRAST	$2,503	$2,503	$41.40 – $2,503
MRI of the lower back (lumbar spine), without contrast: 10 of 15 insurance plan rates Allegiance — All: $310.22 Blue Cross Blue Shield — All: $310.22 Blue Cross Blue Shield — Medicare Advantage: $41.40 Coventry — All: $2,377.85 First Choice Health — All: $323.52 First Health Network — All: $2,377.85 Humana — Medicare Advantage: $41.40 Interwest Health — All: $2,127.55 Montana Health CoOp — All: $2,427.91 Pacific Source — All: $2,503
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Inpatient or outpatient · Hospital (facility) fee · modifier SD In the file: PHY L-SPINE WO CONTRAST MRI	$214	$214	Not listed in the file
CT scan of the pelvis, with contrast CPT 72193 · Inpatient or outpatient · Hospital (facility) fee In the file: CT PELVIS W	$1,321	$1,321	$60.81 – $1,321
CT scan of the pelvis, with contrast: 10 of 15 insurance plan rates Allegiance — All: $370.69 Blue Cross Blue Shield — All: $370.69 Blue Cross Blue Shield — Medicare Advantage: $60.81 Coventry — All: $1,254.95 First Choice Health — All: $392 First Health Network — All: $1,254.95 Humana — Medicare Advantage: $60.81 Interwest Health — All: $1,122.85 Montana Health CoOp — All: $1,281.37 Pacific Source — All: $1,321
CT scan of the pelvis, with contrast CPT 72193 · Inpatient or outpatient · Hospital (facility) fee · modifier SD In the file: PHY PELVIS CT W CONTRAST	$363	$363	Not listed in the file
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Inpatient or outpatient · Hospital (facility) fee In the file: MRI LOWER EXT LT W JOINT WO CONTRAST	$2,009	$2,009	$5.50 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $2,009
MRI of a leg joint (such as the knee), without contrast: 10 of 15 insurance plan rates Allegiance — All: $328.63 Blue Cross Blue Shield — All: $328.63 Blue Cross Blue Shield — Medicare Advantage: $5.50 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) Coventry — All: $1,908.55 First Choice Health — All: $341.31 First Health Network — All: $1,908.55 Humana — Medicare Advantage: $5.50 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) Interwest Health — All: $1,707.65 Montana Health CoOp — All: $1,948.73 Pacific Source — All: $2,009
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Inpatient or outpatient · Hospital (facility) fee In the file: MRI LOWER EXT RT W JOINT WO CONTRAST	$2,009	$2,009	$5.50 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $2,009
MRI of a leg joint (such as the knee), without contrast: 10 of 15 insurance plan rates Allegiance — All: $328.63 Blue Cross Blue Shield — All: $328.63 Blue Cross Blue Shield — Medicare Advantage: $5.50 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) Coventry — All: $1,908.55 First Choice Health — All: $341.31 First Health Network — All: $1,908.55 Humana — Medicare Advantage: $5.50 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) Interwest Health — All: $1,707.65 Montana Health CoOp — All: $1,948.73 Pacific Source — All: $2,009
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Inpatient or outpatient · Hospital (facility) fee · modifier SD In the file: PHY LOWER EXT W JOINT WO CONTRAST MRI	$226	$226	Not listed in the file
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Inpatient or outpatient · Hospital (facility) fee In the file: CT ABDOMEN PELVIS W	$2,475	$2,475	$7.76 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $2,475
CT scan of the abdomen and pelvis, with contrast: 10 of 15 insurance plan rates Allegiance — All: $491.10 Blue Cross Blue Shield — All: $491.10 Blue Cross Blue Shield — Medicare Advantage: $7.76 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) Coventry — All: $2,351.25 First Choice Health — All: $519.25 First Health Network — All: $2,351.25 Humana — Medicare Advantage: $7.76 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) Interwest Health — All: $2,103.75 Montana Health CoOp — All: $2,400.75 Pacific Source — All: $2,475
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Inpatient or outpatient · Hospital (facility) fee · modifier SD In the file: PHY ABDOMEN/PELVIS CT W CONTRAST	$480	$480	Not listed in the file
Ultrasound of the abdomen, complete CPT 76700 · Inpatient or outpatient · Hospital (facility) fee In the file: US ABDOMINAL COMPLETE	$883	$883	$19.73 – $883
Ultrasound of the abdomen, complete: 10 of 15 insurance plan rates Allegiance — All: $183.50 Blue Cross Blue Shield — All: $183.50 Blue Cross Blue Shield — Medicare Advantage: $19.73 Coventry — All: $838.85 First Choice Health — All: $190.34 First Health Network — All: $838.85 Humana — Medicare Advantage: $19.73 Interwest Health — All: $750.55 Montana Health CoOp — All: $856.51 Pacific Source — All: $883
Ultrasound of the abdomen, complete CPT 76700 · Inpatient or outpatient · Hospital (facility) fee · modifier SD In the file: PHY ABDOMINAL COMPLETE US	$218	$218	Not listed in the file
Pregnancy ultrasound (after the first trimester) CPT 76805 · Inpatient or outpatient · Hospital (facility) fee In the file: US OB > OR = 14WK 1 GEST	$591	$591	$27.49 – $591
Pregnancy ultrasound (after the first trimester): 10 of 15 insurance plan rates Allegiance — All: $214 Blue Cross Blue Shield — All: $214 Blue Cross Blue Shield — Medicare Advantage: $27.49 Coventry — All: $561.45 First Choice Health — All: $218.38 First Health Network — All: $561.45 Humana — Medicare Advantage: $27.49 Interwest Health — All: $502.35 Montana Health CoOp — All: $573.27 Pacific Source — All: $591
Pregnancy ultrasound (after the first trimester) CPT 76805 · Inpatient or outpatient · Hospital (facility) fee · modifier SD In the file: PHY OB >=14 WEEKS 1 GEST US	$249	$249	Not listed in the file
Transvaginal ultrasound CPT 76830 · Inpatient or outpatient · Hospital (facility) fee In the file: US TRANSVAGINAL	$392	$392	$25.23 – $392
Transvaginal ultrasound: 10 of 15 insurance plan rates Allegiance — All: $188.24 Blue Cross Blue Shield — All: $188.24 Blue Cross Blue Shield — Medicare Advantage: $25.23 Coventry — All: $372.40 First Choice Health — All: $194.65 First Health Network — All: $372.40 Humana — Medicare Advantage: $25.23 Interwest Health — All: $333.20 Montana Health CoOp — All: $380.24 Pacific Source — All: $392
Transvaginal ultrasound CPT 76830 · Inpatient or outpatient · Hospital (facility) fee · modifier SD In the file: PHY TRANSVAGINAL US	$218	$218	Not listed in the file
Diagnostic mammogram, one breast CPT 77065 · Inpatient or outpatient · Hospital (facility) fee In the file: MAMMO LT BREAST DX W CAD	$372	$372	$48.84 – $372
Diagnostic mammogram, one breast: 10 of 15 insurance plan rates Allegiance — All: $197.70 Blue Cross Blue Shield — All: $197.70 Blue Cross Blue Shield — Medicare Advantage: $48.84 Coventry — All: $353.40 First Choice Health — All: $202.74 First Health Network — All: $353.40 Humana — Medicare Advantage: $48.84 Interwest Health — All: $316.20 Montana Health CoOp — All: $360.84 Pacific Source — All: $372
Diagnostic mammogram, one breast CPT 77065 · Inpatient or outpatient · Hospital (facility) fee In the file: MAMMO RT BREAST DX W CAD	$372	$372	$48.84 – $372
Diagnostic mammogram, one breast: 10 of 15 insurance plan rates Allegiance — All: $197.70 Blue Cross Blue Shield — All: $197.70 Blue Cross Blue Shield — Medicare Advantage: $48.84 Coventry — All: $353.40 First Choice Health — All: $202.74 First Health Network — All: $353.40 Humana — Medicare Advantage: $48.84 Interwest Health — All: $316.20 Montana Health CoOp — All: $360.84 Pacific Source — All: $372
Diagnostic mammogram, one breast CPT 77065 · Inpatient or outpatient · Hospital (facility) fee · modifier SD In the file: PHY MAMMO DIAGNOSTIC 1 BREAST W CAD	$160	$160	Not listed in the file
Diagnostic mammogram, both breasts CPT 77066 · Inpatient or outpatient · Hospital (facility) fee In the file: MAMMO DX BILAT W CAD	$408	$408	$54.02 – $408
Diagnostic mammogram, both breasts: 10 of 15 insurance plan rates Allegiance — All: $250.28 Blue Cross Blue Shield — All: $250.28 Blue Cross Blue Shield — Medicare Advantage: $54.02 Coventry — All: $387.60 First Choice Health — All: $256.12 First Health Network — All: $387.60 Humana — Medicare Advantage: $54.02 Interwest Health — All: $346.80 Montana Health CoOp — All: $395.76 Pacific Source — All: $408
Diagnostic mammogram, both breasts CPT 77066 · Inpatient or outpatient · Hospital (facility) fee · modifier SD In the file: PHY MAMMO DIAGNOSTIC BILAT W CAD	$202	$202	Not listed in the file
Screening mammogram, both breasts CPT 77067 · Inpatient or outpatient · Hospital (facility) fee In the file: MAMMO SCREEN BILAT W CAD	$328	$328	$71.81 – $328
Screening mammogram, both breasts: 10 of 15 insurance plan rates Allegiance — All: $201.91 Blue Cross Blue Shield — All: $201.91 Blue Cross Blue Shield — Medicare Advantage: $71.81 Coventry — All: $311.60 First Choice Health — All: $206.51 First Health Network — All: $311.60 Humana — Medicare Advantage: $71.81 Interwest Health — All: $278.80 Montana Health CoOp — All: $318.16 Pacific Source — All: $328
Screening mammogram, both breasts CPT 77067 · Inpatient or outpatient · Hospital (facility) fee In the file: MAMMO SCREEN SPECIAL W CAD	$302	$302	$71.81 – $302
Screening mammogram, both breasts: 10 of 15 insurance plan rates Allegiance — All: $201.91 Blue Cross Blue Shield — All: $201.91 Blue Cross Blue Shield — Medicare Advantage: $71.81 Coventry — All: $286.90 First Choice Health — All: $206.51 First Health Network — All: $286.90 Humana — Medicare Advantage: $71.81 Interwest Health — All: $256.70 Montana Health CoOp — All: $292.94 Pacific Source — All: $302
Screening mammogram, both breasts CPT 77067 · Inpatient or outpatient · Hospital (facility) fee · modifier SD In the file: PHY MAMMO SCREEN BILAT W CAD	$163	$163	Not listed in the file

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	$22.61 – $29.33
Electrocardiogram (ECG/EKG) with reading: 10 of 15 insurance plan rates Allegiance — All: $22.61 Blue Cross Blue Shield — All: $22.61 First Choice Health — All: $22.65 UHC — All: $29.33 Blue Cross Blue Shield — Medicare Advantage: 100% (a percentage in the contract, not a dollar amount) Coventry — All: 95% (a percentage in the contract, not a dollar amount) First Health Network — All: 95% (a percentage in the contract, not a dollar amount) Humana — Medicare Advantage: 100% (a percentage in the contract, not a dollar amount) Interwest Health — All: 85% (a percentage in the contract, not a dollar amount) Montana Health CoOp — All: 97% (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	$1,394.42 – $1,583.61
Left heart catheterization (diagnostic): 10 of 15 insurance plan rates Allegiance — All: $1,394.42 Blue Cross Blue Shield — All: $1,394.42 First Choice Health — All: $1,507.60 UHC — All: $1,583.61 Blue Cross Blue Shield — Medicare Advantage: 100% (a percentage in the contract, not a dollar amount) Coventry — All: 95% (a percentage in the contract, not a dollar amount) First Health Network — All: 95% (a percentage in the contract, not a dollar amount) Humana — Medicare Advantage: 100% (a percentage in the contract, not a dollar amount) Interwest Health — All: 85% (a percentage in the contract, not a dollar amount) Montana Health CoOp — All: 97% (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	$1,016.37 – $1,262.63
Heart rhythm study (electrophysiology evaluation): 10 of 15 insurance plan rates Allegiance — All: $1,033.20 Blue Cross Blue Shield — All: $1,016.37 First Choice Health — All: $1,077.32 UHC — All: $1,262.63 Blue Cross Blue Shield — Medicare Advantage: 100% (a percentage in the contract, not a dollar amount) Coventry — All: 95% (a percentage in the contract, not a dollar amount) First Health Network — All: 95% (a percentage in the contract, not a dollar amount) Humana — Medicare Advantage: 100% (a percentage in the contract, not a dollar amount) Interwest Health — All: 85% (a percentage in the contract, not a dollar amount) Montana Health CoOp — All: 97% (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	$1,455.94 – $1,993.73
Heart rhythm study with ablation for atrial fibrillation: 10 of 15 insurance plan rates Allegiance — All: $1,455.94 Blue Cross Blue Shield — All: $1,455.94 First Choice Health — All: $1,771.81 UHC — All: $1,993.73 Blue Cross Blue Shield — Medicare Advantage: 100% (a percentage in the contract, not a dollar amount) Coventry — All: 95% (a percentage in the contract, not a dollar amount) First Health Network — All: 95% (a percentage in the contract, not a dollar amount) Humana — Medicare Advantage: 100% (a percentage in the contract, not a dollar amount) Interwest Health — All: 85% (a percentage in the contract, not a dollar amount) Montana Health CoOp — All: 97% (a percentage in the contract, not a dollar amount)
Sleep study (overnight, in a sleep lab) CPT 95810 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: POLYSOM 6/> YRS 4/> PARAM	Not listed in the file	Not listed in the file	$86.37 – $1,051.87
Sleep study (overnight, in a sleep lab): 10 of 15 insurance plan rates Allegiance — All: $984.30 Blue Cross Blue Shield — All: $984.30 Blue Cross Blue Shield — Medicare Advantage: $86.37 First Choice Health — All: $968.94 Humana — Medicare Advantage: $86.37 Tricare — All: $86.37 UHC — All: $1,051.87 UHC — Medicare Advantage: $86.37 VA Health — All: $86.37 Coventry — All: 95% (a percentage in the contract, not a dollar amount)

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: OT EXERCISE THERAPEUTIC	$124	$124	$28.14 – $124
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 15 insurance plan rates Allegiance — All: $46.27 Blue Cross Blue Shield — All: $46.27 Blue Cross Blue Shield — Medicare Advantage: $28.14 Coventry — All: $117.80 First Choice Health — All: $46.91 First Health Network — All: $117.80 Humana — Medicare Advantage: $28.14 Interwest Health — All: $105.40 Montana Health CoOp — All: $120.28 Pacific Source — All: $124
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Inpatient or outpatient · Hospital (facility) fee In the file: PT EXERCISE THERAPEUTIC	$124	$124	$28.14 – $124
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 15 insurance plan rates Allegiance — All: $46.27 Blue Cross Blue Shield — All: $46.27 Blue Cross Blue Shield — Medicare Advantage: $28.14 Coventry — All: $117.80 First Choice Health — All: $46.91 First Health Network — All: $117.80 Humana — Medicare Advantage: $28.14 Interwest Health — All: $105.40 Montana Health CoOp — All: $120.28 Pacific Source — All: $124
Physical therapy evaluation (low complexity) CPT 97161 · Inpatient or outpatient · Hospital (facility) fee In the file: PT EVAL LOW COMPLEX CHG	$247	$247	$2.91 – $247
Physical therapy evaluation (low complexity): 10 of 15 insurance plan rates Allegiance — All: $158.27 Blue Cross Blue Shield — All: $158.27 Blue Cross Blue Shield — Medicare Advantage: $2.91 Coventry — All: $234.65 First Choice Health — All: $159.60 First Health Network — All: $234.65 Humana — Medicare Advantage: $2.91 Interwest Health — All: $209.95 Montana Health CoOp — All: $239.59 Pacific Source — All: $247
Physical therapy evaluation (moderate complexity) CPT 97162 · Inpatient or outpatient · Hospital (facility) fee In the file: PT EVAL MOD COMPLEX CHG	$268	$268	$8.41 – $268
Physical therapy evaluation (moderate complexity): 10 of 15 insurance plan rates Allegiance — All: $158.27 Blue Cross Blue Shield — All: $158.27 Blue Cross Blue Shield — Medicare Advantage: $8.41 Coventry — All: $254.60 First Choice Health — All: $159.60 First Health Network — All: $254.60 Humana — Medicare Advantage: $8.41 Interwest Health — All: $227.80 Montana Health CoOp — All: $259.96 Pacific Source — All: $268
Physical therapy evaluation (high complexity) CPT 97163 · Inpatient or outpatient · Hospital (facility) fee In the file: PT EVAL HIGH COMPLEX CHG	$288	$288	$8.73 – $288
Physical therapy evaluation (high complexity): 10 of 15 insurance plan rates Allegiance — All: $158.27 Blue Cross Blue Shield — All: $158.27 Blue Cross Blue Shield — Medicare Advantage: $8.73 Coventry — All: $273.60 First Choice Health — All: $159.60 First Health Network — All: $273.60 Humana — Medicare Advantage: $8.73 Interwest Health — All: $244.80 Montana Health CoOp — All: $279.36 Pacific Source — All: $288
Psychotherapy, 30 minutes CPT 90832 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PSYTX W PT 30 MINUTES	Not listed in the file	Not listed in the file	$107.30 – $120.41
Psychotherapy, 30 minutes: 10 of 15 insurance plan rates Allegiance — All: $107.79 Blue Cross Blue Shield — All: $107.79 First Choice Health — All: $107.30 UHC — All: $120.41 Blue Cross Blue Shield — Medicare Advantage: 100% (a percentage in the contract, not a dollar amount) Coventry — All: 95% (a percentage in the contract, not a dollar amount) First Health Network — All: 95% (a percentage in the contract, not a dollar amount) Humana — Medicare Advantage: 100% (a percentage in the contract, not a dollar amount) Interwest Health — All: 85% (a percentage in the contract, not a dollar amount) Montana Health CoOp — All: 97% (a percentage in the contract, not a dollar amount)
Psychotherapy, 45 minutes CPT 90834 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PSYTX W PT 45 MINUTES	Not listed in the file	Not listed in the file	$141.27 – $160.13
Psychotherapy, 45 minutes: 10 of 15 insurance plan rates Allegiance — All: $142.49 Blue Cross Blue Shield — All: $142.49 First Choice Health — All: $141.27 UHC — All: $160.13 Blue Cross Blue Shield — Medicare Advantage: 100% (a percentage in the contract, not a dollar amount) Coventry — All: 95% (a percentage in the contract, not a dollar amount) First Health Network — All: 95% (a percentage in the contract, not a dollar amount) Humana — Medicare Advantage: 100% (a percentage in the contract, not a dollar amount) Interwest Health — All: 85% (a percentage in the contract, not a dollar amount) Montana Health CoOp — All: 97% (a percentage in the contract, not a dollar amount)
Psychotherapy, 60 minutes CPT 90837 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PSYTX W PT 60 MINUTES	Not listed in the file	Not listed in the file	$207.05 – $239.59
Psychotherapy, 60 minutes: 10 of 15 insurance plan rates Allegiance — All: $210.32 Blue Cross Blue Shield — All: $210.32 First Choice Health — All: $207.05 UHC — All: $239.59 Blue Cross Blue Shield — Medicare Advantage: 100% (a percentage in the contract, not a dollar amount) Coventry — All: 95% (a percentage in the contract, not a dollar amount) First Health Network — All: 95% (a percentage in the contract, not a dollar amount) Humana — Medicare Advantage: 100% (a percentage in the contract, not a dollar amount) Interwest Health — All: 85% (a percentage in the contract, not a dollar amount) Montana Health CoOp — All: 97% (a percentage in the contract, not a dollar amount)
Family psychotherapy, without the patient CPT 90846 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: FAMILY PSYTX W/O PT 50 MIN	Not listed in the file	Not listed in the file	$152.05 – $175.42
Family psychotherapy, without the patient: 10 of 15 insurance plan rates Allegiance — All: $153.53 Blue Cross Blue Shield — All: $153.53 First Choice Health — All: $152.05 UHC — All: $175.42 Blue Cross Blue Shield — Medicare Advantage: 100% (a percentage in the contract, not a dollar amount) Coventry — All: 95% (a percentage in the contract, not a dollar amount) First Health Network — All: 95% (a percentage in the contract, not a dollar amount) Humana — Medicare Advantage: 100% (a percentage in the contract, not a dollar amount) Interwest Health — All: 85% (a percentage in the contract, not a dollar amount) Montana Health CoOp — All: 97% (a percentage in the contract, not a dollar amount)
Family psychotherapy, with the patient CPT 90847 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: FAMILY PSYTX W/PT 50 MIN	Not listed in the file	Not listed in the file	$157.99 – $181.53
Family psychotherapy, with the patient: 10 of 15 insurance plan rates Allegiance — All: $160.37 Blue Cross Blue Shield — All: $160.37 First Choice Health — All: $157.99 UHC — All: $181.53 Blue Cross Blue Shield — Medicare Advantage: 100% (a percentage in the contract, not a dollar amount) Coventry — All: 95% (a percentage in the contract, not a dollar amount) First Health Network — All: 95% (a percentage in the contract, not a dollar amount) Humana — Medicare Advantage: 100% (a percentage in the contract, not a dollar amount) Interwest Health — All: 85% (a percentage in the contract, not a dollar amount) Montana Health CoOp — All: 97% (a percentage in the contract, not a dollar amount)
Group psychotherapy CPT 90853 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: GROUP PSYCHOTHERAPY	Not listed in the file	Not listed in the file	$37.20 – $47.67
Group psychotherapy: 10 of 15 insurance plan rates Allegiance — All: $37.86 Blue Cross Blue Shield — All: $37.86 First Choice Health — All: $37.20 UHC — All: $47.67 Blue Cross Blue Shield — Medicare Advantage: 100% (a percentage in the contract, not a dollar amount) Coventry — All: 95% (a percentage in the contract, not a dollar amount) First Health Network — All: 95% (a percentage in the contract, not a dollar amount) Humana — Medicare Advantage: 100% (a percentage in the contract, not a dollar amount) Interwest Health — All: 85% (a percentage in the contract, not a dollar amount) Montana Health CoOp — All: 97% (a percentage in the contract, not a dollar amount)

Procedures and surgery

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Removal of breast growth (open surgery) CPT 19120 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: REMOVAL OF BREAST LESION	Not listed in the file	Not listed in the file	$114.51 – $887.46
Removal of breast growth (open surgery): 10 of 15 insurance plan rates Allegiance — All: $665.66 Blue Cross Blue Shield — All: $665.66 Blue Cross Blue Shield — Medicare Advantage: $114.51 First Choice Health — All: $670.23 Humana — Medicare Advantage: $114.51 Tricare — All: $114.51 UHC — All: $887.46 UHC — Medicare Advantage: $114.51 VA Health — All: $114.51 Coventry — All: 95% (a percentage in the contract, not a dollar amount)
Total hip replacement CPT 27130 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: TOTAL HIP ARTHROPLASTY	Not listed in the file	Not listed in the file	$253.92 – $2,396.51
Total hip replacement: 10 of 15 insurance plan rates Allegiance — All: $2,031.17 Blue Cross Blue Shield — All: $2,031.17 Blue Cross Blue Shield — Medicare Advantage: $253.92 First Choice Health — All: $2,050.04 Humana — Medicare Advantage: $253.92 Tricare — All: $253.92 UHC — All: $2,396.51 UHC — Medicare Advantage: $253.92 VA Health — All: $253.92 Coventry — All: 95% (a percentage in the contract, not a dollar amount)
Total knee replacement CPT 27447 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: TOTAL KNEE ARTHROPLASTY	Not listed in the file	Not listed in the file	$363.57 – $2,393.46
Total knee replacement: 10 of 15 insurance plan rates Allegiance — All: $2,028.01 Blue Cross Blue Shield — All: $2,028.01 Blue Cross Blue Shield — Medicare Advantage: $363.57 First Choice Health — All: $2,047.88 Humana — Medicare Advantage: $363.57 Tricare — All: $363.57 UHC — All: $2,393.46 UHC — Medicare Advantage: $363.57 VA Health — All: $363.57 Coventry — All: 95% (a percentage in the contract, not a dollar amount)
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: SHO ARTHRS SRG DECOMPRESSION	Not listed in the file	Not listed in the file	$13.26 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $308.65
Shoulder arthroscopy: shaving of shoulder bone: 10 of 15 insurance plan rates Allegiance — All: $268.16 Blue Cross Blue Shield — All: $268.16 Blue Cross Blue Shield — Medicare Advantage: $13.26 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) First Choice Health — All: $274.99 Humana — Medicare Advantage: $13.26 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) Tricare — All: $13.26 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) UHC — All: $308.65 UHC — Medicare Advantage: $13.26 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) VA Health — All: $13.26 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) Coventry — All: 95% (a percentage in the contract, not a dollar amount)
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: KNEE ARTHROSCOPY/SURGERY	Not listed in the file	Not listed in the file	$239.69 – $953.47
Knee arthroscopy: removal of torn cartilage (meniscus): 10 of 15 insurance plan rates Allegiance — All: $867.57 Blue Cross Blue Shield — All: $867.57 Blue Cross Blue Shield — Medicare Advantage: $239.69 First Choice Health — All: $869.19 Humana — Medicare Advantage: $239.69 Tricare — All: $239.69 UHC — All: $953.47 UHC — Medicare Advantage: $239.69 VA Health — All: $239.69 Coventry — All: 95% (a percentage in the contract, not a dollar amount)
Removal of tonsils and adenoids (under age 12) CPT 42820 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: REMOVE TONSILS AND ADENOIDS	Not listed in the file	Not listed in the file	$464.25 – $504.85
Removal of tonsils and adenoids (under age 12): 10 of 15 insurance plan rates Allegiance — All: $465.33 Blue Cross Blue Shield — All: $465.33 First Choice Health — All: $464.25 UHC — All: $504.85 Blue Cross Blue Shield — Medicare Advantage: 100% (a percentage in the contract, not a dollar amount) Coventry — All: 95% (a percentage in the contract, not a dollar amount) First Health Network — All: 95% (a percentage in the contract, not a dollar amount) Humana — Medicare Advantage: 100% (a percentage in the contract, not a dollar amount) Interwest Health — All: 85% (a percentage in the contract, not a dollar amount) Montana Health CoOp — All: 97% (a percentage in the contract, not a dollar amount)
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EGD DIAGNOSTIC BRUSH WASH	Not listed in the file	Not listed in the file	$122.27 – $487.75
Upper GI endoscopy (diagnostic): 10 of 15 insurance plan rates Allegiance — All: $190.87 Blue Cross Blue Shield — All: $190.87 Blue Cross Blue Shield — Medicare Advantage: $122.27 First Choice Health — All: $193.57 Humana — Medicare Advantage: $122.27 Tricare — All: $122.27 UHC — All: $487.75 UHC — Medicare Advantage: $122.27 VA Health — All: $122.27 Coventry — All: 95% (a percentage in the contract, not a dollar amount)
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EGD BIOPSY SINGLE/MULTIPLE	Not listed in the file	Not listed in the file	$63.08 – $649.70
Upper GI endoscopy with biopsy: 10 of 15 insurance plan rates Allegiance — All: $215.58 Blue Cross Blue Shield — All: $215.58 Blue Cross Blue Shield — Medicare Advantage: $63.08 First Choice Health — All: $217.84 Humana — Medicare Advantage: $63.08 Tricare — All: $63.08 UHC — All: $649.70 UHC — Medicare Advantage: $63.08 VA Health — All: $63.08 Coventry — All: 95% (a percentage in the contract, not a dollar amount)
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: DIAGNOSTIC COLONOSCOPY	Not listed in the file	Not listed in the file	$30.08 – $575.74
Colonoscopy (diagnostic): 10 of 15 insurance plan rates Allegiance — All: $286.56 Blue Cross Blue Shield — All: $286.56 Blue Cross Blue Shield — Medicare Advantage: $30.08 First Choice Health — All: $436.75 Humana — Medicare Advantage: $30.08 Tricare — All: $30.08 UHC — All: $575.74 UHC — Medicare Advantage: $30.08 VA Health — All: $30.08 Coventry — All: 95% (a percentage in the contract, not a dollar amount)
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COLONOSCOPY AND BIOPSY	Not listed in the file	Not listed in the file	$64.69 – $741.39
Colonoscopy with biopsy: 10 of 15 insurance plan rates Allegiance — All: $311.27 Blue Cross Blue Shield — All: $311.27 Blue Cross Blue Shield — Medicare Advantage: $64.69 First Choice Health — All: $315.97 Humana — Medicare Advantage: $64.69 Tricare — All: $64.69 UHC — All: $741.39 UHC — Medicare Advantage: $64.69 VA Health — All: $64.69 Coventry — All: 95% (a percentage in the contract, not a dollar amount)
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COLONOSCOPY W/LESION REMOVAL	Not listed in the file	Not listed in the file	$70.84 – $774.40
Colonoscopy with removal of polyps (snare): 10 of 15 insurance plan rates Allegiance — All: $393.82 Blue Cross Blue Shield — All: $393.82 Blue Cross Blue Shield — Medicare Advantage: $70.84 First Choice Health — All: $401.70 Humana — Medicare Advantage: $70.84 Tricare — All: $70.84 UHC — All: $774.40 UHC — Medicare Advantage: $70.84 VA Health — All: $70.84 Coventry — All: 95% (a percentage in the contract, not a dollar amount)
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	$42.05 – $454.13
Ultrasound of the lower bowel by endoscope: 10 of 15 insurance plan rates Allegiance — All: $399.08 Blue Cross Blue Shield — All: $399.08 Blue Cross Blue Shield — Medicare Advantage: $42.05 First Choice Health — All: $406.56 Humana — Medicare Advantage: $42.05 Tricare — All: $42.05 UHC — All: $454.13 UHC — Medicare Advantage: $42.05 VA Health — All: $42.05 Coventry — All: 95% (a percentage in the contract, not a dollar amount)
Screening colonoscopy (not high risk) HCPCS G0121 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COLON CA SCRN NOT HI RSK IND	Not listed in the file	Not listed in the file	$8.09 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $576.35
Screening colonoscopy (not high risk): 10 of 15 insurance plan rates Allegiance — All: $287.09 Blue Cross Blue Shield — All: $287.09 Blue Cross Blue Shield — Medicare Advantage: $8.09 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) First Choice Health — All: $437.83 Humana — Medicare Advantage: $8.09 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) Tricare — All: $8.09 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) UHC — All: $576.35 UHC — Medicare Advantage: $8.09 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) VA Health — All: $8.09 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) Coventry — All: 95% (a percentage in the contract, not a dollar amount)
Gallbladder removal by laparoscope CPT 47562 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LAPAROSCOPIC CHOLECYSTECTOMY	Not listed in the file	Not listed in the file	$1,047.39 – $1,475.97
Gallbladder removal by laparoscope: 10 of 15 insurance plan rates Allegiance — All: $1,047.39 Blue Cross Blue Shield — All: $1,047.39 Blue Cross Blue Shield — Medicare Advantage: $1,475.97 First Choice Health — All: $1,065.46 Humana — Medicare Advantage: $1,475.97 Tricare — All: $1,475.97 UHC — All: $1,172.89 UHC — Medicare Advantage: $1,475.97 VA Health — All: $1,475.97 Coventry — All: 95% (a percentage in the contract, not a dollar amount)
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PRP I/HERN INIT REDUC >5 YR	Not listed in the file	Not listed in the file	$168.53 – $927.19
Groin (inguinal) hernia repair, age 5 or older: 10 of 15 insurance plan rates Allegiance — All: $831.82 Blue Cross Blue Shield — All: $831.82 Blue Cross Blue Shield — Medicare Advantage: $168.53 First Choice Health — All: $844.39 Humana — Medicare Advantage: $168.53 Tricare — All: $168.53 UHC — All: $927.19 UHC — Medicare Advantage: $168.53 VA Health — All: $168.53 Coventry — All: 95% (a percentage in the contract, not a dollar amount)
Prostate biopsy CPT 55700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: BIOPSY OF PROSTATE	Not listed in the file	Not listed in the file	$202.96 – $692.54
Prostate biopsy: 10 of 15 insurance plan rates Allegiance — All: $202.96 Blue Cross Blue Shield — All: $202.96 Blue Cross Blue Shield — Medicare Advantage: $692.54 First Choice Health — All: $203.82 Humana — Medicare Advantage: $692.54 Tricare — All: $692.54 UHC — All: $433.35 UHC — Medicare Advantage: $692.54 VA Health — All: $692.54 Coventry — All: 95% (a percentage in the contract, not a dollar amount)
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	$208.96 – $2,548.10
Prostate removal by laparoscope (radical prostatectomy): 10 of 15 insurance plan rates Allegiance — All: $1,868.17 Blue Cross Blue Shield — All: $1,831.36 Blue Cross Blue Shield — Medicare Advantage: $208.96 First Choice Health — All: $2,266.80 Humana — Medicare Advantage: $208.96 Tricare — All: $208.96 UHC — All: $2,548.10 UHC — Medicare Advantage: $208.96 VA Health — All: $208.96 Coventry — All: 95% (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	$47.87 – $2,420.96
Hysteroscopy with biopsy of the uterus lining: 10 of 15 insurance plan rates Allegiance — All: $363.85 Blue Cross Blue Shield — All: $363.85 Blue Cross Blue Shield — Medicare Advantage: $47.87 First Choice Health — All: $366.66 Humana — Medicare Advantage: $47.87 Tricare — All: $47.87 UHC — All: $2,420.96 UHC — Medicare Advantage: $47.87 VA Health — All: $47.87 Coventry — All: 95% (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	$155.64 – $445.56
Spinal injection, lower back (epidural), with imaging guidance: 10 of 15 insurance plan rates Allegiance — All: $155.64 Blue Cross Blue Shield — All: $155.64 Blue Cross Blue Shield — Medicare Advantage: $335.43 First Choice Health — All: $156.91 Humana — Medicare Advantage: $335.43 Tricare — All: $335.43 UHC — All: $445.56 UHC — Medicare Advantage: $335.43 VA Health — All: $335.43 Coventry — All: 95% (a percentage in the contract, not a dollar amount)
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: NJX AA&/STRD TFRM EPI L/S 1	Not listed in the file	Not listed in the file	$39.79 – $411.33
Nerve root injection, lower back, with imaging guidance: 10 of 15 insurance plan rates Allegiance — All: $174.57 Blue Cross Blue Shield — All: $174.57 Blue Cross Blue Shield — Medicare Advantage: $39.79 First Choice Health — All: $175.78 Humana — Medicare Advantage: $39.79 Tricare — All: $39.79 UHC — All: $411.33 UHC — Medicare Advantage: $39.79 VA Health — All: $39.79 Coventry — All: 95% (a percentage in the contract, not a dollar amount)
Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CARPAL TUNNEL SURGERY	Not listed in the file	Not listed in the file	$114.83 – $766.44
Carpal tunnel release: 10 of 15 insurance plan rates Allegiance — All: $702.99 Blue Cross Blue Shield — All: $702.99 Blue Cross Blue Shield — Medicare Advantage: $114.83 First Choice Health — All: $699.34 Humana — Medicare Advantage: $114.83 Tricare — All: $114.83 UHC — All: $766.44 UHC — Medicare Advantage: $114.83 VA Health — All: $114.83 Coventry — All: 95% (a percentage in the contract, not a dollar amount)
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	$487.44 – $574.52
Laser treatment of clouding after cataract surgery: 10 of 15 insurance plan rates Allegiance — All: $488.47 Blue Cross Blue Shield — All: $488.47 Blue Cross Blue Shield — Medicare Advantage: $488.43 First Choice Health — All: $487.44 Humana — Medicare Advantage: $488.43 Tricare — All: $488.43 UHC — All: $574.52 UHC — Medicare Advantage: $488.43 VA Health — All: $488.43 Coventry — All: 95% (a percentage in the contract, not a dollar amount)
Cataract removal with lens implant CPT 66984 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: XCAPSL CTRC RMVL W/O ECP	Not listed in the file	Not listed in the file	$185.02 – $944.30
Cataract removal with lens implant: 10 of 15 insurance plan rates Allegiance — All: $848.64 Blue Cross Blue Shield — All: $848.64 Blue Cross Blue Shield — Medicare Advantage: $185.02 First Choice Health — All: $848.70 Humana — Medicare Advantage: $185.02 Tricare — All: $185.02 UHC — All: $944.30 UHC — Medicare Advantage: $185.02 VA Health — All: $185.02 Coventry — All: 95% (a percentage in the contract, not a dollar amount)

Pregnancy and childbirth

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Vaginal delivery, with care before and after CPT 59400 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OBSTETRICAL CARE	Not listed in the file	Not listed in the file	$26.85 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $3,838.34
Vaginal delivery, with care before and after: 10 of 15 insurance plan rates Allegiance — All: $3,838.34 Blue Cross Blue Shield — All: $3,838.34 Blue Cross Blue Shield — Medicare Advantage: $26.85 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) First Choice Health — All: $3,833.17 Humana — Medicare Advantage: $26.85 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) Tricare — All: $26.85 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) UHC — All: $3,760.70 UHC — Medicare Advantage: $26.85 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) VA Health — All: $26.85 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) Coventry — All: 95% (a percentage in the contract, not a dollar amount)
Cesarean delivery (C-section), with care before and after CPT 59510 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CESAREAN DELIVERY	Not listed in the file	Not listed in the file	$220.93 – $4,267.92
Cesarean delivery (C-section), with care before and after: 10 of 15 insurance plan rates Allegiance — All: $4,267.92 Blue Cross Blue Shield — All: $4,267.92 Blue Cross Blue Shield — Medicare Advantage: $220.93 First Choice Health — All: $4,232.72 Humana — Medicare Advantage: $220.93 Tricare — All: $220.93 UHC — All: $4,170.81 UHC — Medicare Advantage: $220.93 VA Health — All: $220.93 Coventry — All: 95% (a percentage in the contract, not a dollar amount)
Vaginal delivery after a previous C-section, with care before and after CPT 59610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: VBAC DELIVERY	Not listed in the file	Not listed in the file	$564.12 – $4,023.95
Vaginal delivery after a previous C-section, with care before and after: 10 of 15 insurance plan rates Allegiance — All: $4,023.95 Blue Cross Blue Shield — All: $4,023.95 Blue Cross Blue Shield — Medicare Advantage: $564.12 First Choice Health — All: $4,008.41 Humana — Medicare Advantage: $564.12 Tricare — All: $564.12 UHC — All: $3,956.90 UHC — Medicare Advantage: $564.12 VA Health — All: $564.12 Coventry — All: 95% (a percentage in the contract, not a dollar amount)

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: 10 of 15 insurance plan rates Allegiance — All: 85% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield — All: 100% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield — Medicare Advantage: 100% (a percentage in the contract, not a dollar amount) Coventry — All: 95% (a percentage in the contract, not a dollar amount) First Choice Health — All: 85% (a percentage in the contract, not a dollar amount) First Health Network — All: 95% (a percentage in the contract, not a dollar amount) Humana — Medicare Advantage: 100% (a percentage in the contract, not a dollar amount) Interwest Health — All: 85% (a percentage in the contract, not a dollar amount) Montana Health CoOp — All: 97% (a percentage in the contract, not a dollar amount) Pacific Source — All: 100% (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: 10 of 15 insurance plan rates Allegiance — All: 85% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield — All: 100% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield — Medicare Advantage: 100% (a percentage in the contract, not a dollar amount) Coventry — All: 95% (a percentage in the contract, not a dollar amount) First Choice Health — All: 85% (a percentage in the contract, not a dollar amount) First Health Network — All: 95% (a percentage in the contract, not a dollar amount) Humana — Medicare Advantage: 100% (a percentage in the contract, not a dollar amount) Interwest Health — All: 85% (a percentage in the contract, not a dollar amount) Montana Health CoOp — All: 97% (a percentage in the contract, not a dollar amount) Pacific Source — All: 100% (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: 10 of 15 insurance plan rates Allegiance — All: 85% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield — All: 100% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield — Medicare Advantage: 100% (a percentage in the contract, not a dollar amount) Coventry — All: 95% (a percentage in the contract, not a dollar amount) First Choice Health — All: 85% (a percentage in the contract, not a dollar amount) First Health Network — All: 95% (a percentage in the contract, not a dollar amount) Humana — Medicare Advantage: 100% (a percentage in the contract, not a dollar amount) Interwest Health — All: 85% (a percentage in the contract, not a dollar amount) Montana Health CoOp — All: 97% (a percentage in the contract, not a dollar amount) Pacific Source — All: 100% (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: 10 of 15 insurance plan rates Allegiance — All: 85% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield — All: 100% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield — Medicare Advantage: 100% (a percentage in the contract, not a dollar amount) Coventry — All: 95% (a percentage in the contract, not a dollar amount) First Choice Health — All: 85% (a percentage in the contract, not a dollar amount) First Health Network — All: 95% (a percentage in the contract, not a dollar amount) Humana — Medicare Advantage: 100% (a percentage in the contract, not a dollar amount) Interwest Health — All: 85% (a percentage in the contract, not a dollar amount) Montana Health CoOp — All: 97% (a percentage in the contract, not a dollar amount) Pacific Source — All: 100% (a percentage in the contract, not a dollar amount)

Source: Fallon Medical Complex Hospital’s standard charges file (fallonmed.goredde.com, CSV, CMS template 3.0.0; it can be a very large file), last updated by the hospital on March 28, 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	202 S 4th St W, Baker, MT 59313
County	Fallon County
State	Montana
Phone	(406) 778‑3331
Emergency services	Yes
Ownership	Voluntary non-profit - Private
Medicare overall rating	Not rated by CMS
CMS Certification Number	271301
Name in Medicare records	FALLON MEDICAL COMPLEX HOSPITAL
Profile level	Medicare data + hospital website
Name on the hospital’s website	Fallon Medical Complex
Official website	fallonmedical.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 ZIP code areas (Gazetteer) — approximate position (center of the ZIP code area) used for distances

From the hospital’s website

Numbers match the citations above. Checked 2026-10-30.

Fallon Medical Complex — fallonmedical.org
Hospital — fallonmedical.org
Rehab Services — fallonmedical.org
Social Services — fallonmedical.org
About — fallonmedical.org
Diagnostic Imaging — fallonmedical.org
Lab — fallonmedical.org

Fallon Medical Complex Hospital

Summary

Profile from official sources

At a glance

Quick answers

Specialties and care areas^[5][6][8]

Treatments^[4][9][12]

Programs and centers^[5][7]

Emergency care (hospital website)^{[4][5][8][12]}

Visiting and practical information

Recognition^[9]

Doctors and clinicians (23)

Main specialties

Doctors with a page on this site (23)

Other emergency rooms nearby

Other hospitals near Baker

Community care nearby

Clinics and urgent care

Pharmacies

About the Medicare star rating

Medicare quality data

Return visits to the hospital (readmissions)

Emergency room times and sepsis care

ER wait times and Medicare ratings nearby

Prices

Office and emergency visits

Lab tests

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

Heart tests and sleep study

Physical therapy and mental health

Procedures and surgery

Pregnancy and childbirth

Hospital stays (whole stay, MS-DRG)

Hospital information

Sources

From the hospital’s website

Fallon Medical Complex Hospital

Summary

Profile from official sources

At a glance

Quick answers

Specialties and care areas[5][6][8]

Treatments[4][9][12]

Programs and centers[5][7]

Emergency care (hospital website)[4][5][8][12]

Visiting and practical information

Recognition[9]

Doctors and clinicians (23)

Main specialties

Doctors with a page on this site (23)

Other emergency rooms nearby

Other hospitals near Baker

Community care nearby

Clinics and urgent care

Pharmacies

About the Medicare star rating

Medicare quality data

Return visits to the hospital (readmissions)

Emergency room times and sepsis care

ER wait times and Medicare ratings nearby

Prices

Office and emergency visits

Lab tests

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

Heart tests and sleep study

Physical therapy and mental health

Procedures and surgery

Pregnancy and childbirth

Hospital stays (whole stay, MS-DRG)

Hospital information

Sources

From the hospital’s website

Specialties and care areas^[5][6][8]

Treatments^[4][9][12]

Programs and centers^[5][7]

Emergency care (hospital website)^{[4][5][8][12]}

Recognition^[9]